Prevalence and Factors Associated with Permanent Hypocalcemia Following Total Thyroidectomy

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.