Oral calcium and vitamin D supplementation after total thyroidectomy

El-Shinawi, Mohamed; El-Anwar, Aly; Nada, Mohamed Abu; Youssef, Tarek; Fakhry, Essam; Raslan, Salah; El-Gohry, Hatem

doi:10.4103/0973-0354.138553

Cited by 13 publications

(17 citation statements)

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“…The primary search identified 1010 articles. Only 15 of 30 full‐text articles assessed satisfied the inclusion criteria ( Fig . ).…”

Section: Resultsmentioning

confidence: 99%

“…All studies used similar symptoms in the assessment of clinical hypocalcaemia. Regarding biochemical hypocalcaemia, 11 studies used a threshold of 8 mg/dl and three a threshold of 8·4 mg/dl. Data on permanent hypocalcaemia/hypoparathyroidism were reported in only five studies.…”

Section: Resultsmentioning

confidence: 99%

“…Some studies included a large proportion of patients with cancer 15,20,24,25,27 or hyperthyroidism 14,18,19,21,22,26,27 . El-Shinawi et al 17 O-charoenrat et al 23 Ravikumar et al 16 Roh and Park 24 Roh et al 25 Bellantone et al 19 Choe et al 20 Jaan et al 15 Ravikumar et al 16 The duration of treatment ranged from 1 to 28 days, and the cumulative dose of calcium and vitamin D3 ranged from 0⋅15 to 5 g and from 400 units to 20 μg respectively. All studies used similar symptoms in the assessment of clinical hypocalcaemia.…”

Section: Resultsmentioning

confidence: 99%

“…Test for subgroup differences: Arer et al 14 Bellantone et al 19 Choe et al 20 Choe et al 20 Jaan et al 15 Ravikumar et al 16 El-Shinawi et al 17 O-charoenrat et al 23 Ravikumar et al 16 Roh and Park et al 24 Roh et al 25 Abstracts were reviewed, and those related to the research question were selected for further analysis. The inclusion criteria were: RCTs comparing the prophylactic administration of oral calcium +/-vitamin D3/activated vitamin D3 versus calcium alone, vitamin D3 alone or treatment based on serum calcium levels measured after total thyroidectomy for any cause.…”

Section: Intravenous Calcium Versus No Treatmentmentioning

confidence: 99%

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Meta-analysis of routine calcium/vitamin D3 supplementationversusserum calcium level-based strategy to prevent postoperative hypocalcaemia after thyroidectomy

Sanábria

Rojas

Arevalo

2019

British Journal of Surgery

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Background The aim was to assess the effectiveness of routine administration of calcium +/– vitamin D3 compared with a serum calcium level‐based strategy to prevent symptomatic hypocalcaemia after thyroidectomy. Methods RCTs comparing routine supplementation of calcium +/– vitamin D3 with treatment based on serum calcium levels measured after total thyroidectomy, published between 1980 and 2017, were identified in MEDLINE, Embase, LILACS and Google Scholar databases. Risk of bias was evaluated using the Cochrane Collaboration tool. Risk differences were calculated by random‐effects meta‐analysis. Meta‐regression and cumulative meta‐analysis were used to explore the best therapeutic approach. Results Fifteen studies with 3037 patients were included, and seven treatment comparisons were made. Routine supplementation with calcium + vitamin D3 offered a lower risk of symptomatic (risk difference (RD) –0·25, 95 per cent c.i. –0·32 to –0·18) and biochemical (RD –0·24, –0·31 to –0·17) hypocalcaemia than treatment based on measurement of calcium levels. The number needed to treat was 4 (95 per cent c.i. 3 to 6) for symptomatic hypocalcaemia. No publication bias was found; although heterogeneity was high for some comparisons, sensitivity analysis did not change the main results. Conclusion Routine postoperative administration of calcium + vitamin D3 is effective in decreasing the rate of symptomatic and biochemical hypocalcaemia.

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“…The primary search identified 1010 articles. Only 15 of 30 full‐text articles assessed satisfied the inclusion criteria ( Fig . ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Intravenous Calcium Versus No Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Meta-analysis of routine calcium/vitamin D3 supplementationversusserum calcium level-based strategy to prevent postoperative hypocalcaemia after thyroidectomy

Sanábria

Rojas

Arevalo

2019

British Journal of Surgery

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“…Many surgeons routinely supplement calcium and vitamin D in all patients who have total thyroidectomies (17,18). Although this practice is effective in reducing the number of symptomatic patients, it can be inconvenient because the treatment is expensive and poorly tolerated.…”

Section: Resultsmentioning

confidence: 99%

Postoperative calcium levels as a diagnostic measure for hypoparathyroidism after total thyroidectomy

Rosa

Matos

Cernea

et al. 2015

Arch. Endocrinol. Metab.

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Objective: The aim of the present study was to identify a fast, efficient and low-cost method to diagnose hypoparathyroidism after total thyroidectomy. Materials and methods: One hundred and forty medical records, which contained patients' clinical and laboratory data, were retrospectively analyzed. Patient parathyroid hormone values, which were obtained immediately following operation, were compared with their ionized calcium levels the morning after surgery. This comparison was used to examine the correlation between the two variables in predicting hypoparathyroidism because measuring calcium levels is low-cost and more available in the hospitals compared to measuring parathormone (PTH) levels. Results: There was a positive and statistically significant correlation between PTH and ionized calcium values (Pearson correlation coefficient, r = 0.456; p < 0.0001). The values of first postoperative day ionized calcium levels (stratified by the 1.10 mmol/l cut-off value) were tested as a diagnostic measure for hypoparathyroidism, and a PTH < 15 pg/mL obtained immediately following operation served as a reference. This analysis showed that ionized calcium levels measured on the first postoperative day had a sensitivity of 45.6% (95% CI 30.9-61.0%), a specificity of 88.9% (95% CI 80.5-94.5%) and an accuracy of 76.7% (95% CI 68.7-83.5%) as a diagnostic measure for hypoparathyroidism. Conclusion: In conclusion, we demonstrated that patients who had high ionized calcium levels on the first postoperative day also had high PTH levels immediately following operation and, therefore, they had lower rates of hypoparathyroidism. Arch Endocrinol Metab. 2015;59(5):428-33

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