Abstract
BackgroundTransient post thyroidectomy hypocalcemia occurs in up to 30% of patients. We evaluated the effect of vitamin D deficiency on post thyroidectomy hypocalcaemia.MethodsThis is a prospective study which was conducted from November 2010 to January 2013 and a total of 35 patients were included and data was analyzed regarding the relation between preoperative vitamin D3 levels and occurrence of post- thyroidectomy hypocalcemia. Patients were divided into two groups dependent upon the preoperative serum vitamin D level: group 1 with vitamin D levels <20 ng/ml and group 2 with serum vitamin D levels ≥20 ng/ml. Hypocalcemia was defined as a postoperative calcium level <8.5 mg/dl.ResultsThere was a difference in postoperative hypocalcemia between the two vitamin D groups. In patients with serum vitamin D ≤20 ng/ml mean pre-operative and post-operative serum calcium levels were 9.3 ± 0.5 and 8.4 ± 0.58 g dl (p < .001) whereas in patients with serum vitamin D levels >20 ng/ml mean pre-operative and post-operative serum calcium were 9.52 ± 0.64 and 8.9 ± 0.5 (p = ns).ConclusionsPre-operative serum vitamin D levels have got positive correlation with serum calcium levels in early post-operative period. Patients with serum vitamin D levels <20 ng/ml are highly likely to develop early post-operative hypocalcaemia and the difference between pre-operative and post-operative serum calcium levels in vitamin D deficient patients was significant (p < 0.001).
Highlights
Hypocalcemia is a well-known complication and concern following thyroid surgery
Many factors are postulated to increase the risk of hypocalcemia, including old age Graves’ disease, surgical techniques, concurrent neck dissection, large surgical volumes, and the surgeon’s experience, which have all been shown to increase the risk of hypocalcemia [4,5,6]
It has been suggested that the combination of calcitriol and hydrochlorothiazide after thyroidectomy may reduce the risk of hypocalcemia [8]
Summary
Hypocalcemia is a well-known complication and concern following thyroid surgery. in most cases it is only temporary, post-thyroidectomy hypocalcemia can lead to an increased cost by prolonging the length of stay and increasing the need for expensive medications, frequent biochemical tests and multiple outpatient visits [1]. The incidence of transient hypocalcemia has been estimated to occur between 3% to 30% of cases even after preservation of one or more parathyroids [2]. Much less frequent, still occurs, with an incidence of around 2-4% reported in the literature [3]. Patients may develop more severe symptoms such as carpopedal spasm, tetany, Many factors are postulated to increase the risk of hypocalcemia, including old age Graves’ disease, surgical techniques, concurrent neck dissection, large surgical volumes, and the surgeon’s experience, which have all been shown to increase the risk of hypocalcemia [4,5,6]. Few studies have suggested the role of 25hydroxycholecalciferol (vitamin D3) deficiency in the occurrence of hypocalcaemia after thyroidectomy [4]. Transient post thyroidectomy hypocalcemia occurs in up to 30% of patients. We evaluated the effect of vitamin D deficiency on post thyroidectomy hypocalcaemia
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