Correlating Pre-Operative Vitamin D Status with Post-Thyroidectomy Hypocalcemia

Falcone, Todd E.; Stein, Daniel J.; Jumaily, Jeffrey S.; Pearce, Elizabeth N.; Holick, Michael F.; McAneny, David; Jalisi, Scharukh; Grillone, Gregory A.; Stone, Michael D.; Devaiah, Anand K.; Noordzij, J. Pieter

doi:10.4158/ep14264.or

Cited by 28 publications

(18 citation statements)

References 23 publications

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“…In six studies, age was found to have a statistically significant association with transient biochemical hypocalcaemia, 12,26,30,33,46,47 with four papers reporting this only in younger patients 12,26,30,33 and two papers reporting significance in older patients. 46,47 This is in comparison to 26 studies 11,16–19,24,25,27–29,31,32,38–40,42–44,49,52,54,56,58–61 that found no significant association to age.…”

Section: Resultscontrasting

confidence: 62%

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

2020

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AbstractObjectiveHypocalcaemia is the most common complication after total or completion thyroidectomy. This study assesses recent evidence on predictive factors for post-thyroidectomy hypocalcaemia in order to identify the patients affected and aid prevention.MethodTwo authors independently assessed articles and extracted data to provide a narrative synthesis. This study was an updated systematic search and narrative review regarding predictors of post-thyroidectomy hypocalcaemia using the Ovid Medline, Embase, Cochrane and Cinahl databases. Results were limited to papers published from January 2012 to August 2019.ResultsSixty-three observational studies with a total of 210 401 patients met the inclusion criteria. The median incidence was 27.5 per cent for transient biochemical hypocalcaemia, 12.5 per cent for symptomatic hypocalcaemia and 2.2 per cent for permanent hypocalcaemia. The most frequent statistically significant predictor of hypocalcaemia was peri-operative parathyroid hormone level. Symptomatic hypocalcaemia and permanent hypocalcaemia were seen more frequently in patients undergoing concomitant neck dissection.ConclusionMany factors have been studied for their link to post-thyroidectomy hypocalcaemia, and this study assesses the recent evidence presented in each case.

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Section: Resultscontrasting

confidence: 62%

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

2020

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“…This result is in accordance with other studies. 36 , 37 Recently, Danan and Shonka 26 demonstrated that vitamin D level is a significant predictor of postoperative hypocalcemia in patients in whom ≥3 parathyroid glands were identified. However, in our retrospective study, we did not have the data for preoperative vitamin D levels.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study

Wang¹,

Bhandari²,

Yang³

et al. 2017

CMAR

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BackgroundHypocalcemia is one of the most common postoperative complications following thyroid surgery in clinical practice. The occurrence of hypocalcemia is mainly attributed to hypoparathyroidism when parathyroid glands are devascularized, injured, or dissected during the surgery. The aim of this study was to analyze the risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy.Patients and methodsA total of 278 patients who underwent thyroid surgery were analyzed retrospectively. Univariate analysis and multivariable logistic regression were performed to discover the risk factors for hypocalcemia and hypoparathyroidism.ResultsPostoperative hypocalcemia occurred in 76 (27.3%) patients and hypoparathyroidism occurred in 42 (15.1%) patients. Seven factors were significantly related to the presence of postoperative hypocalcemia, namely, age (P=0.049), gender (P=0.015), lateral lymph node dissection (P=0.017), operation type (P<0.001), preoperative parathyroid hormone (PTH) level (P=0.035), operation time (P=0.001), and applying carbon nanoparticles (CNs; P=0.007). Our result revealed that gender (P=0.014), lateral lymph node dissection (P=0.038), operation type (P<0.001), operative time (P<0.001), and applying CNs (P=0.001) had a significant correlation with postoperative hypoparathyroidism.ConclusionThese findings were crucial for guiding surgeons to prevent the occurrence of hypocalcemia and hypoparathyroidism.

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“…More recently, Falcone and colleagues described a large retrospective study of 264 total or completion thyroidectomies performed within the University of Virginia Health System between 2007 and 2011 (10). Serum 25-hydroxyvitamin D levels were obtained within 21 days of surgery, and an unspecified number of patients received vitamin D repletion therapy prior to surgery.…”

Section: Discussionmentioning

confidence: 99%

Does Pre-Operative Vitamin D Deficiency Predict Postoperative Hypocalcemia After Thyroidectomy?

et al. 2017

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Introduction: Postoperative hypocalcemia is frequent after total thyroidectomy. The role of preoperative vitamin D levels in the pathogenesis of this condition has not been studied under the most current guidelines for evaluation of the role of vitamin D in calcium homeostasis. We hypothesized that patients with preoperative vitamin D deficiency are more likely to suffer from postoperative hypocalcemia, thereby requiring prolonged hospitalization. Methods: A retrospective chart review of patients undergoing total thyroidectomy at the University of New Mexico Hospital between 2005 and 2014 was performed. Patients who underwent parathyroidectomy were excluded. The study included 30 patients who had a 25-hydroxyvitamin D levels obtained within 12 months before surgery. Results: 12 patients with vitamin D deficiency (VDD; 25-hydroxyvitamin D ≤ 20 ng/ml) were compared to 18 patients without vitamin D deficiency (Non-VDD; 25-hydroxyvitamin D > 20 ng/ml). The mean nadir postoperative ionized calcium concentration was lower in the VDD group (0.99±0.10 vs. 1.06±0.06 mmol/l, p=0.04) (Ref Range = 1.15–1.27 mmol/l), as was the postoperative concentration of phosphorus (3.48±0.60 vs. 4.17±0.84 mg/dl, p=0.03). VDD patients had a longer length of stay (4.3±4.4 vs. 1.7±1.5 days, p=0.03). Three patients in the VDD group required intravenous calcium for treatment of symptomatic hypocalcemia, but none of the Non-VDD patients required this intervention (p=0.054). Conclusions: Preoperative vitamin D deficiency is associated with an increased risk of postoperative hypocalcemia and a prolonged length of stay in patients undergoing total thyroidectomy. Vitamin D replacement before thyroidectomy may improve postsurgical outcomes in vitamin D deficient patients.

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Correlating Pre-Operative Vitamin D Status with Post-Thyroidectomy Hypocalcemia

Cited by 28 publications

References 23 publications

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study

Does Pre-Operative Vitamin D Deficiency Predict Postoperative Hypocalcemia After Thyroidectomy?

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