Incident and Factor Associated with Hypocalcemia Post Total Thyroidectomy

Abstract

Objective: This study aimed to determine the incident rate and identify risk factors associated with postoperative hypocalcemia in patients who underwent total thyroidectomy at Phra Nakhon Sri Ayutthaya Hospital.

Method: This retrospective descriptive study analyzed medical records, including outpatient and inpatient charts, operative reports, and pathology results, were retrospectively reviewed. “of all patients who underwent total thyroidectomy in the ENT department of Phra Nakhon Sri Ayutthaya Hospital between 2017 and 2022. Data collected included patient demographics, operative time, estimated blood loss, pathological diagnosis, parathyroid gland identification within the surgical specimen, postoperative calcium levels measured 24-48 hours after surgery, and outpatient follow-up records for six months. Statistical analysis to determine factors associated with postoperative hypocalcemia was conducted using chi-square tests, mulitivariate analysis and considered statistically significant at a p-value of less than 0.05.”

Result: Of the 177 patients, 62.2% were diagnosed with thyroid cancer. A total of 72.3% of patients experienced postoperative hypocalcemia, with 63.3% developing persistent hypocalcemia. Patients who underwent total thyroidectomy in a single procedure were more likely to experience hypocalcemia compared to those who underwent a two-stage procedure. Operative time, identification of 1-2 parathyroid glands in the surgical specimen, and a postoperative day 1 calcium level below 8.5 mg/dL were significantly associated with the development of hypocalcemia (p-values 0.02, 0.01, and <0.01, respectively)

Conclusion: Surgical procedures time, those with identified parathyroid glands within the surgical specimen, or those exhibiting a postoperative day 1 serum calcium level below 8.5 mg/dL were associated with an increased risk of postoperative hypocalcemia.

Keyword: Hypocalcemia, total thyroidectomy