Abstract
Background Postoperative transient hypocalcemia (TH) is a common complication of total thyroidectomy. This retrospective study evaluated the clinical utility of preoperative vitamin D3 injection for the prevention of TH after total thyroidectomy. Methods We included 2294 patients who underwent total thyroidectomy from January 2015 until October 2018 and retrospectively analyzed their data by complete chart review at our hospital. The patients were divided into two groups: vitamin D3 injection (VDI; n = 342) and vitamin D3 noninjection (VDN; n = 1952). TH was defined as serum calcium <8.2 mg/dL and signs or symptoms of hypocalcemia. Results The mean preoperative serum 25-hydroxyvitamin D (25-OHD) levels of the VDI group were significantly lower than those of the VDN group (16.5 ± 6.9 ng/mL vs 19.4 ± 8.7 ng/mL, p < 0.001). Multivariate analysis indicated that the significant risk factors of TH include vitamin D noninjection (hazard ratio (HR): 1.717, 95% confidence interval (CI): 1.282–2.300, p < 0.001), male gender (HR: 1.427, 95% CI: 1.117–1.822, p = 0.004), and capsular extension (HR: 1.273, 95% CI: 1.011–1.603, p = 0.040). Conclusions Preoperative vitamin D3 injection significantly contributed to the prevention of TH after total thyroidectomy. Further prospective or multicenter studies must be conducted to determine the effect of vitamin D3 injection.
Highlights
Total thyroidectomy (TT) has been accepted as the treatment of choice for some malignant and benign thyroid diseases [1]
Some authors have suggested that oral vitamin D and calcium supplements should be routinely administered prophylactically during the postoperative period to reduce the incidence of symptomatic hypocalcemia [16, 17]
We retrospectively reviewed the medical records of 2457 patients who underwent TT at Yonsei University Hospital (Seoul, Korea) between January 2015 and October 2018; 102 patients were excluded based on a diagnosis of permanent hypocalcemia, and 61 patients were excluded as they were lost to follow-up or had inadequate follow-up data. e final analysis dataset included 2294 patients whose data were collected and analyzed based on a complete review of medical charts and pathology reports
Summary
Postoperative transient hypocalcemia (TH) is a common complication of total thyroidectomy. is retrospective study evaluated the clinical utility of preoperative vitamin D3 injection for the prevention of TH after total thyroidectomy. Postoperative transient hypocalcemia (TH) is a common complication of total thyroidectomy. Is retrospective study evaluated the clinical utility of preoperative vitamin D3 injection for the prevention of TH after total thyroidectomy. We included 2294 patients who underwent total thyroidectomy from January 2015 until October 2018 and retrospectively analyzed their data by complete chart review at our hospital. E patients were divided into two groups: vitamin D3 injection (VDI; n 342) and vitamin D3 noninjection (VDN; n 1952). E mean preoperative serum 25-hydroxyvitamin D (25-OHD) levels of the VDI group were significantly lower than those of the VDN group (16.5 ± 6.9 ng/mL vs 19.4 ± 8.7 ng/mL, p < 0.001). Preoperative vitamin D3 injection significantly contributed to the prevention of TH after total thyroidectomy. Further prospective or multicenter studies must be conducted to determine the effect of vitamin D3 injection
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