Incidence and Associated Factors of Post-Thyroidectomy Hypocalcaemia (Single-Center Study)

Abstract

Background: Thyroid surgery represents a widely used intervention since thyroid nodules detection is increasing. Hypocalcemia following total thyroidectomy is a common complication that is sometimes difficult to correct. Apparently there were no studies conducted in Yemen on hypocalcemia after thyroidectomy and their associated factors.

Objective: The aim of our study was to estimate incidence of hypocalcemia following thyroidectomy and determine its associated factors.

Patients and Methods: From January 2021 to march 2022, a cross-sectional study was conducted at Al Thawra Modern General Hospital, Sana’a city, Yemen. We included all patients who underwent total or completion thyroidectomy with normal range perioperative calcium level, including those who underwent concomitant neck dissection. All patients who underwent lobectomy, resection of thyroid gland, and diagnosed pathology of parathyroid glands were excluded from the analysis. Data were collected directly from patients during pre and postoperative periods using a pre-prepared questionnaire. The primary outcome measures were the rate of biochemical hypocalcaemia

Results: A total of 50 patients enrolled in this study. Females outnumbered males (74% versus 26% respectively) with female to male ratio 3:1. The mean age of the patients at surgery was 38.46 ± 11.5 years with a range of 15-70 years. The majority (76%) of the patients underwent a total thyroidectomy without neck dissection, whereas total thyroidectomy with neck dissection was performed in 8% patients. Completion thyroidectomy without neck dissection and with neck dissection were done in 12% and 4% patients, respectively. Incidence of biochemical hypocalcaemia within 24 hours of surgery was 54% observed in 27 patients (mean =8.5 ± 0.65 mg/dl). There were no statistically differences between males and females in age, postoperative calcium, type of thyroid disease and type of surgery. Decreased pre-operative calcium, malignancy, and underwent total thyroidectomy were significantly related to the development of hypocalcemia.

Conclusion: Incidence of hypocalcemia following thyroidectomy was high in our patients. Decreased pre-operative calcium, malignancy, and underwent total thyroidectomy were associated factors of hypocalcemia following thyroidectomy at Al Thawra Modern General Hospital, Sana’a city, Yemen.