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Submitted: 20 July 2016 Modified: 20 July 2016
HERDIN Record #: NCR-JAFES-16072016541411

Incidence and risk factors for post-thyroidectomy hypocalcemia.

Section of Endocrinology, Diabetes and Metabolism - St. Luke's Medical Center

Abstract

Objective. This study aimed to determine the incidence and risk factors for post-thyroidectomy hypocalcemia.


Methodology. This was a retrospective study of 242 patients who underwent total or completion thyroidectomy from 2011-2014 at the St. Luke's Medical Center, Quezon City, Philippines. The overall and type-specific incidences of hypocalcemia were determined. Patient and surgery-related factors were assessed and hypocalcemic events described.


Results. Overall incidence of hypocalcemia is 11.98% distributed into symptomatic (10.74%) and asymptomatic (1.24%). The following patient-related factors were not found to be significantly associated with hypocalcemia: age, gender, thyroid disease and thyroid gland weight. Among surgery-related factors, the presence of concomitant complications of thyroidectomy (hoarseness and/or hematoma) and inadvertent parathyroidectomy were significantly associated with hypocalcemia both in the univariate [p=0.046; OR 2.369 (95%CI: 0.995-5.643) and p=0.027; OR 2.426 (95%CI: 1.084-5.432), respectively] and multivariate analyses [p=0.025; OR 2.842 (95%CI: 1.142-7.069) and p=0.013; OR 2.941 (95%CI: 1.252-6.907), respectively]. Other surgery-related factors were not found to be significantly associated with hypocalcemia: extent of thyroidectomy [total vs completion]; neck dissection; surgery duration (hours); and surgeon [consultant vs. trainee].


Among those with symptomatic hypocalcemia, manifestations occurred 29.85±23.07 hours post-operatively and these were: Chvostek's (80.8%), acral paresthesia (76.9%), perioral numbness (46.1%), carpopedal spasm (15.3%), Trousseau's (7.7%) and cramps (3.8%). Those who presented with manifestations of hypocalcemia but with normal serum iCa post-operatively comprised 33.9% of the study population and the majority presented with Chvostek's sign (52%) and acral paresthesia (50%).


Conclusion. In this study, hoarseness and/or hematoma and inadvertent parathyroidectomy are risk factors for post-thyroidectomy hypocalcemia. Closer monitoring of these patients for hypocalcemia may be necessary.

This study aimed to determine the incidence and risk factors for post-thyroidectomy hypocalcemia.

1.
Publication Type:
Journal
Publication Sub Type:
Journal Article, Original
Title:
Journal of the ASEAN Federation of Endocrine Societies
Frequency:
Semi-Annual
Publication Date:
May 2016
Volume:
31
Issue:
1
Page(s):
30-36
Publisher:
ASEAN Federation of Endocrine Societies

Objectives

This study aimed to determine the incidence and risk factors for post-thyroidectomy hypocalcemia.

LocationCall NumberAvailable FormatAvailability
http://www.asean-endocrinejournal.org (632) 6373162 Fulltext External Link (View)
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