Hypoparathyroidism after total thyroidectomy: reactive to symptoms supplementation

Area of Science:

• Endocrinology
• Surgical Complications
• Thyroid Surgery

Background:

• Postoperative hypoparathyroidism (PH) is a common complication following total thyroidectomy (TT).
• Current management strategies for PH are not standardized.
• This study investigated a reactive supplementation approach for symptomatic PH.

Purpose of the Study:

• To evaluate the outcomes of reactive vitamin-calcium supplementation for symptomatic PH.
• To identify risk factors associated with symptomatic PH.
• To analyze risk factors for readmission due to PH.

Main Methods:

• A retrospective analysis of patients undergoing TT from 2017 to 2022.
• Implementation of a reactive supplementation protocol for symptomatic PH.
• Assessment of primary outcome: severe PH leading to readmission.

Main Results:

• 98 out of 307 patients (31.9%) developed symptomatic PH.
• Independent risk factors for symptomatic PH included age and postoperative day 1 (POD1) PTH levels.
• The readmission rate for symptomatic PH requiring IV supplementation was 6.8% (18 patients).
• POD1 albumin-adjusted calcium and PTH levels were identified as predictors for readmission.

Conclusions:

• Reactive supplementation for symptomatic PH is a safe and effective management strategy.
• This approach does not negatively impact morbidity, mortality, or readmission rates.
• Findings support current literature regarding PH management after TT.