Risk factors for hypocalcemia after total thyroidectomy.

Area of Science:

• Endocrinology
• Surgical Oncology
• Neurosurgery

Background:

• Hypocalcemia is a frequent complication following total thyroidectomy, with transient cases reported in up to 68% of patients.
• Understanding risk factors is crucial for managing post-operative outcomes.

Purpose of the Study:

• To determine the incidence of hypocalcemia after thyroidectomy.
• To identify clinical and pathological risk factors associated with post-operative hypocalcemia.

Main Methods:

• Retrospective chart review of 337 patients undergoing total thyroidectomy between 2016 and 2020 at a tertiary care teaching hospital.
• Data collected included clinical, biochemical, and pathological information.
• Statistical analysis sought correlations between variables and hypocalcemia occurrence.

Main Results:

• Post-operative hypocalcemia occurred in 12.7% of patients.
• Bivariate analysis indicated intraoperative parathyroid gland injury, prolonged surgical time (>2.5 hours), lymph node dissection, and drain placement as significant risk factors.
• Multivariable analysis confirmed intraoperative parathyroid injury as the sole statistically significant risk factor.

Conclusions:

• Intraoperative injury to the parathyroid glands is the most significant risk factor for developing post-operative hypocalcemia after thyroidectomy.
• Surgeon awareness and prevention of parathyroid injury are critical for mitigating this complication.