Abstract
The objective of this study is to examine the risk of hypocalcemia after thyroidectomy in patients taking histamine-2 receptor antagonists. Retrospective cohort study. Multicenter, single database. Thirty-four thousand two hundred eighteen patients treated with total thyroidectomy from 2011 to 2022 were identified via the TriNetX Research Network. We compared the incidence of transient (0-1 month and 1-6 months following thyroidectomy) and permanent (6-12 months following thyroidectomy) postthyroidectomy hypocalcemia in patients with and without H2 receptor antagonists. Propensity score matching and sensitivity analysis were done to control for additional risk factors. Patients were divided into 2 cohorts: those with an H2 receptor antagonist prescription before surgery (n = 5108) and those without (n = 29,110). 44.9% and 11.6% of thyroidectomy patients taking H2 receptor antagonists had hypocalcemia compared to 38.3% and 8.2% of patients without H2 receptor antagonists at 0 to 1 month and 6 to 12 months, respectively. Patients taking H2 receptor antagonists had a significantly increased risk of experiencing hypocalcemia at 0 to 1 month, 1 to 6 months, and 6 to 12 months. Patients taking H2 receptor antagonists were also at increased risk for visiting the emergency department and receiving intravenous calcium replenishment at 1 and 6 months following surgery. Sensitivity analysis continued to yield significant results at all time points. Patients taking H2 receptor antagonists may be at increased risk of short and long-term hypocalcemia after thyroid surgery. This is the first retrospective cohort study examining the risk of hypocalcemia after thyroidectomy in patients taking H2 receptor antagonists.
Published Version
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