DOES PRE-OPERATIVE VITAMIN D DEFICIENCY PREDICT POSTOPERATIVE HYPOCALCEMIA AFTER THYROIDECTOMY?

Area of Science:

• Endocrinology
• Surgical Outcomes
• Nutritional Science

Background:

• Postoperative hypocalcemia is a common complication following total thyroidectomy.
• The influence of pre-operative vitamin D status on calcium homeostasis post-thyroidectomy requires further investigation.
• Vitamin D plays a crucial role in calcium regulation.

Purpose of the Study:

• To investigate the association between pre-operative vitamin D deficiency and the incidence of postoperative hypocalcemia.
• To determine if pre-operative vitamin D levels impact hospital length of stay after total thyroidectomy.
• To evaluate the role of vitamin D in calcium homeostasis following thyroid surgery.

Main Methods:

• Retrospective chart review of 30 patients undergoing total thyroidectomy.
• Exclusion of patients with intentional parathyroidectomy.
• Analysis of pre-operative 25-hydroxyvitamin D levels (obtained within 12 months prior to surgery).

Main Results:

• Patients with pre-operative vitamin D deficiency (VDD) had significantly lower nadir postoperative ionized calcium levels (P=.04) and phosphorus levels (P=.03).
• Vitamin D deficient patients experienced a longer length of hospital stay (4.3 days vs. 1.7 days, P=.03).
• Three VDD patients required intravenous calcium for symptomatic hypocalcemia, compared to none in the non-VDD group (P=.054).

Conclusions:

• Pre-operative vitamin D deficiency is linked to a higher risk of postoperative hypocalcemia and prolonged hospitalization after total thyroidectomy.
• Vitamin D replacement therapy prior to thyroidectomy may be beneficial for patients with vitamin D deficiency.
• Optimizing vitamin D levels pre-surgery could enhance recovery and reduce complications.