Post total thyroidectomy hypocalcemia

Pradeep, P. V.; Ramalingam, K.; Jayashree, B.

doi:10.4103/0022-3859.109479

Cited by 21 publications

(28 citation statements)

References 21 publications

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“…33 Biochemical postoperative hypocalcemia after total thyroidectomy. 34 In our study it is also found the same result. But in that study Pradeep et al found age was not significant in postoperative hypocalcemia.…”

Section: Discussionsupporting

confidence: 87%

Hypocalcaemia after Total Thyroidectomy

Islam¹,

Khan

Fattah

et al. 2020

Bangladesh J of Otorhinolaryngology

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Objective: To determine whether postoperative hypocalcemia after total thyroidectomy is more frequent in malignant disease than benign disease. Methods: This is a Cross sectional study. The sample size is 126. All the patients were selected according to the eligibility criteria by purposive sampling. Patients were analyzed for age, gender, thyroid pathology, preoperative serum calcium, postoperative serum calcium. Results: Postoperative hypocalcemia was found in 37 (29.37%) patients. Most patients were female (Male: Female= 1: 4.2). Patients having low preoperative serum calcium had developed more postoperative hypocalcemia (p<0.03). Postoperative hypocalcemia was associated with thyroid pathology (p<0.009) and age (p<0.006), not associated with sex (p<0.907). In multivariate analysis very little association between malignant disease and postoperative hypocalcemia was found (p<0.07). Conclusion: The incidence of postoperative hypocalcemia following total thyroidectomy is 29.4% that is higher than the anticipated but is comparable to other published series. For total thyroidectomy surgeons should be aware of postoperative hypocalcemia but prophylactic calcium and vitamin D supplement is not mandatory in all cases. Bangladesh J Otorhinolaryngol; April 2019; 25(1): 19-27

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Section: Discussionsupporting

confidence: 87%

Hypocalcaemia after Total Thyroidectomy

Islam¹,

Khan

Fattah

et al. 2020

Bangladesh J of Otorhinolaryngology

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“…Low post-operative calcium was the only other commonly assessed biochemical factor that showed a statistically significant positive association with transient biochemical hypocalcaemia in the majority of studies. 12,13,22–24,27,28,31,32,36,37,39,44,45 Positive associations were shown with post-operative calcitonin and post-operative albumin but in only one study. 18 Pre-operative vitamin D, magnesium, phosphate, creatinine, calcitonin and thyroid-stimulating hormone levels showed non-significant associations in the majority of studies where investigated.…”

Section: Resultsmentioning

confidence: 85%

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

2020

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AbstractObjectiveHypocalcaemia is the most common complication after total or completion thyroidectomy. This study assesses recent evidence on predictive factors for post-thyroidectomy hypocalcaemia in order to identify the patients affected and aid prevention.MethodTwo authors independently assessed articles and extracted data to provide a narrative synthesis. This study was an updated systematic search and narrative review regarding predictors of post-thyroidectomy hypocalcaemia using the Ovid Medline, Embase, Cochrane and Cinahl databases. Results were limited to papers published from January 2012 to August 2019.ResultsSixty-three observational studies with a total of 210 401 patients met the inclusion criteria. The median incidence was 27.5 per cent for transient biochemical hypocalcaemia, 12.5 per cent for symptomatic hypocalcaemia and 2.2 per cent for permanent hypocalcaemia. The most frequent statistically significant predictor of hypocalcaemia was peri-operative parathyroid hormone level. Symptomatic hypocalcaemia and permanent hypocalcaemia were seen more frequently in patients undergoing concomitant neck dissection.ConclusionMany factors have been studied for their link to post-thyroidectomy hypocalcaemia, and this study assesses the recent evidence presented in each case.

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“…23 Lombardi et al suggested single serum calcium measurement 12 hours post-operatively after total thyroidectomy. 24 In the present study we used cut off of 7.5 mg% as a predictive factor for development of Hypocalcaemia, which has a sensitivity of 73% & specificity of 84%, as recorded by Pradeep PV et al 25 Lo CY et al used serum calcium level of 7.2 mg% as cut off for defining hypocalcaemia. 26 Another factor closely related to development of post thyroidectomy hypocalcaemia is serum iPTH, which has been reportedly measured in various studies across literature search, both intra-& post-operatively.…”

Section: Discussionmentioning

confidence: 92%

Factors Contributing to Post-Operative Hypocalcaemia After Total Thyroidectomyexperience in a Tertiary Care Govt. Hospital in Eastern India

Basak¹,

Choudhary²,

Roy³

et al. 2019

jemds

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BACKGROUND Postoperative hypocalcaemia is a common complication after total thyroidectomy but most often it is transient. Although these are mostly amenable to calcium and vitamin D supplementation, symptomatic patients sometimes need prolonged hospitalization following thyroid surgery, leading to increased healthcare costs. In the present study, we tried to find out factors which can predict the occurrence of post-operative hypocalcaemia & hypoparathyroidism in total thyroidectomy patients, facilitating their early detection and institution of definitive management in time, preventing emergency admissions & catastrophes. METHODS A prospective observational study was carried out in the Department of ENT & Head-Neck Surgery of a tertiary care govt. hospital in eastern India. Patients who underwent total thyroidectomy for multinodular goitre (MNG) and adenomatoid goitre (AG) or total/completion thyroidectomy for well differentiated thyroid carcinomas (WDTC), in the age group of 20-55 years were included in our study. We recorded the following parameters: Age, gender distribution of cases, type of operation, pre-operative Fine Needle Aspiration Cytology (FNAC) status, size of thyroid nodule operated (based on pre-operative ultrasonographic study), number of parathyroid glands preserved during operation, pre-operative vitamin D levels, post-operative serum calcium levels at 6 hours & 12 hours (positive i.e. increasing slope & non-positive i.e. decreasing/non-changing slope), early post-operative serum iPTH levels (at 6 hours), development of symptomatic hypocalcaemia-transient or permanent. RESULTS In the present study we measured serum calcium level 6 hours & 12 hours post-operatively. It has been found that patients with serum calcium levels on positive slope have lesser chances of occurrence of symptomatic hypocalcaemia & permanent hypocalcaemia than those on non-positive slope. We found that patients having serum iPTH level between 15-65 pg/ml showed lesser propensity to develop hypocalcaemia in comparison with those with serum iPTH level <15 pg/ml. In our study, it has been found that all the 3 cases who developed permanent hypocalcaemia were suffering from vitamin D deficiency; whereas, patients with normal vitamin D levels posed lesser risk of developing significant hypocalcaemia. In our observation, patients with only two parathyroid glands identified per-operatively have more chances of developing hypocalcaemia & those in whom all four parathyroid glands were preserved, very low risk of hypocalcaemia is associated. Furthermore, preservation of functional parathyroid gland with intact blood supply is found to be of immense importance than mere identification of the glands. In our series, it has been noted that with increase in the size of thyroid nodule, chances of hypocalcaemia increases. Patients undergoing complete thyroidectomy for histopathological report of WDTC in a previously benign (based on pre-operative FNAC) thyroid nodule, increased chances of development of post-operative hypocalcaemia. CONCLUSI...

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Post total thyroidectomy hypocalcemia

Abstract: CSH after TT is multi-factorial, and a combination of factors (Hypocalcemia prediction score > 3) can be used to predict it so as to discharge patients within 24 hours after surgery.

Cited by 21 publications

References 21 publications

Hypocalcaemia after Total Thyroidectomy

Hypocalcaemia after Total Thyroidectomy

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

Factors Contributing to Post-Operative Hypocalcaemia After Total Thyroidectomyexperience in a Tertiary Care Govt. Hospital in Eastern India

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