Prevalence and Factors Associated with Permanent Hypocalcemia Following Total Thyroidectomy

Authors

  • Theerayoot Jongsuebsit Department of Otolaryngology, Surin Hospital, Surin province

Keywords:

permanent hypocalcemia, thyroid surgery, total thyroidectomy, completion thyroidectomy, risk factors

Abstract

Background and Objectives: Hypocalcemia is a complication commonly observed after thyroid surgery. Patients may require calcium replacement for the rest of their lives, and serious complications such as seizures and heart arrhythmias may arise, potentially leading to death. Various factors may contribute to the occurrence of hypocalcemia after thyroid surgery, including sex, age, surgery duration, disease pathology, and blood loss during surgery. This study aimed to yet these factors have not been thoroughly investigated at Surin hospital.

Methods: This retrospective descriptive study focused on patients who underwent total or completion thyroidectomy, with evidence of hypocalcemia after surgery. From October 2021 to September 2022, 118 cases were included. Data on sex, age, thyroid specimen weight, surgery duration, estimated blood loss, parathyroid hormone levels at 24-48 hours post-surgery, and occurrences of hypocalcemia during the first 6 months post-surgery were documented.

Results: Among 118 patients diagnosed, the average age was 48.33±17.44 years, and 83.05% were female. The majority of cases were thyroid cancer (69.20%), with 73.56% of patients developing permanent hypocalcemia. The study found that females had 3.04 times higher chance of developing permanent hypocalcemia (95% CI 1.019 - 9.078). Although blood loss 200 ml or more during surgery increased the chance of permanent hypocalcemia by 2.77 times (95% CI 0.289 - 26.597), statistical significance was not reached (p = 0.377). No association between low parathyroid hormone levels and the occurrence of permanent hypocalcemia.

Conclusion: This studied was found hypocalcemia following thyroid surgery in Surin Hospital was high prevalence, possibly due to a higher proportion of patients with thyroid cancer. Females have a greater likelihood of developing permanent hypocalcemia than males.

References

Alqahtani SM, Alatawi AS, Alalawi YS. Post-thyroidectomy hypocalcemia: a single-center experience. Cureus 2021;13(11):e20006. doi:10.7759/cureus.20006

Christou N, Mathonnet M. Complications after total thyroidectomy. J Visc Surg 2013;150(4):249–56. doi:10.1016/j.jviscsurg.2013.04.003

İFlazoğlu N, Onak C, Gül MO, Memi̇Şoğlu E. Factors affecting incidence of hypocalcemia post thyroid surgery. Turk J Endocrinol Metab 2021;25(4):370–8. doi:10.25179/tjem.2021-83669

Ambe PC, Brömling S, Knoefel WT, Rehders A. Prolonged duration of surgery is not a risk factor for postoperative complications in patients undergoing total thyroidectomy: a single center experience in 305 patients. Patient Saf Surg 2014;8(1):45. doi:10.1186/s13037-014-0045-2

Eismontas V, Slepavicius A, Janusonis V, Zeromskas P, Beisa V, Strupas K, et al. Predictors of postoperative hypocalcemia occurring after a total thyroidectomy: results of prospective multicenter study. BMC Surg 2018;18(1):55. doi:10.1245/s10434-014-4077-8

Rio PD, Rossini M, Montana CM, Viani L, Pedrazzi G, Loderer T, et al. Postoperative hypocalcemia: analysis of factors influencing early hypocalcemia development following thyroid surgery. BMC Surg 2019;18(suppl 1):25. doi:10.1186/s12893-019-0483-y

Endocrine Surgery Thyroid Surgery. Thyroidectomy [Internet]. [cited 2024 Feb 3]. Available from: https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/conditions-treated/thyroid/thyroid-surgery

Nair CG, Babu MJC, Menon R, Jacob P. Hypocalcaemia following total thyroidectomy: an analysis of 806 patients. Indian J Endocrinol Metab 2013;17(2):298–303. doi:10.4103/2230-8210.109718

Mu C, Ming X, Tian Y, Liu Y, Yao M, Ni Y, et al. Mapping global epidemiology of thyroid nodules among general population: a systematic review and meta-analysis. Front Oncol 2022;12:1029926. doi: 10.3389/fonc.2022.1029926

Villarroya-Marquina I, Lorente-Poch L, Sancho J, Sitges-Serra A. Influence of gender and women’s age on the prevalence of parathyroid failure after total thyroidectomy for multinodular goiter. Gland Surg 2020;9(2):245–51. doi:10.21037/gs.2020.02.01

Shuchleib-Cung A, Garcia-Gordillo JA, Ferreira-Hermosillo A, Mercado M. Risk factors for hypocalcemia after total thyroidectomy. Cir Cir 2022;90(6):765–9. doi:10.24875/ciru.21000579

Tongol MC, Mirasol R. Incidence and risk factors for post-thyroidectomy hypocalcemia. JAFES 2016;31(1):30–6. doi:10.15605/jafes.031.01.06

Published

2024-06-24

How to Cite

1.
Jongsuebsit T. Prevalence and Factors Associated with Permanent Hypocalcemia Following Total Thyroidectomy. SRIMEDJ [Internet]. 2024 Jun. 24 [cited 2024 Oct. 6];39(3):330-5. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/262107

Issue

Section

Original Articles