Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit

• Published in: Annals of the Royal College of Surgeons of England Vol. 96; no. 3; pp. 219 - 223
• Main Authors: Edafe, O, Prasad, P, Harrison, B J, Balasubramanian, S P
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.04.2014; Royal College of Surgeons
• Subjects: Calcium - blood; Circadian Rhythm; Data collection; Dissection; Endocrine Surgery; Female; Gender differences; Humans; Hypocalcemia - blood; Hypocalcemia - epidemiology; Hypocalcemia - etiology; Incidence; Iodides - therapeutic use; Lymphatic system; Male; Middle Aged; Observer Variation; Patients; Population; Retrospective Studies; Risk Factors; Surgeons; Surgery; Systematic review; Teaching hospitals; Thyroid cancer; Thyroid Diseases - surgery; Thyroidectomy - adverse effects; Vitamin D; United Kingdom > UK; United States > US
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/003588414X13814021679753

Post-thyroidectomy hypocalcaemia is a common complication with significant short and long term morbidity. The aim of this study was to determine the incidence and predictors of post-thyroidectomy hypocalcaemia (as defined by a corrected calcium <2.1 mmol/l) in a tertiary endocrine surgical unit. A total of 238 consecutive patients who underwent completion or bilateral thyroid surgery between 2008 and 2011 were included in this retrospective study. Clinical and biochemical data were obtained from electronic and hard copy medical records. The incidence of post-thyroidectomy hypocalcaemia on first postoperative day (POD1) was 29.0%. There was variation in the incidence of hypocalcaemia depending on the timing of measurement on the first postoperative day. At six months following surgery, 5.5% of patients were on calcium and/or vitamin D supplementation. Factors associated with post-thyroidectomy hypocalcaemia were lower preoperative corrected calcium (p=0.005) and parathyroid gland (PTG) auto-transplant (p=0.001). Other clinical factors such as central lymph node dissection, inadvertent PTG excision, ethnicity, preoperative diagnosis and Lugol's iodine were not associated with post-thyroidectomy hypocalcaemia. The incidence of post-thyroidectomy hypocalcaemia was underestimated by 6% when only POD1 measurements were considered. The timing of measurement on POD1 has an impact on the incidence of post-thyroidectomy hypocalcaemia. Auto-transplantation and lower preoperative calcium were associated with post-thyroidectomy hypocalcaemia.