Occurrence of Clinically Significant Hypocalcemia 6 to 12 Months After Total Thyroidectomy Could Be Overrated: Results of a Prospective Multicenter Study

Abstract

Objective: The aim of this study was to compare 2 groups of patients, normocalcemic and hypocalcemic, 6 to 12 months after total thyroidectomy and to determine the clinical value of the calcium levels on hospital discharge. Summary of background data: Thyroid surgeries are among the most common operations performed in the world. Hypocalcemia after total thyroidectomy is a common complication that is sometimes difficult to correct. Methods: From January 2015 through April 2017, 400 patients were included in this prospective multicenter study. All the patients underwent total thyroidectomy. By way of random of selection, 2 groups of patients were formed: 30 patients who had a normal level of calcium detected in the blood on discharge from the hospital after total thyroidectomy (normocalcemia group), and 30 patients who had a reduced level of calcium in the blood on discharge from the hospital (hypocalcemia group). In these groups of patients, various parameters were determined. Results: The comparison of patient groups with normocalcemia and hypocalcemia on discharge from the hospital and 6 to 12 months after surgery demonstrated that there were no statistically significant factors for postoperative hypocalcemia. Generally, there were no differences between the groups 6 to 12 months after surgery. Conclusions: Treatment with calcium and 25-hydroxyvitamin D preparations after surgery leads to disappearance of both biochemical and clinical expression of hypocalcemia in most cases. On discharge from the hospital, patients with more pronounced hypocalcemia should be administered calcium and calcitriol preparations, even in the absence of clinical symptoms.