Seasonal Difference in Postthyroidectomy Hypocalcemia

Mascarella, Marco A.; Forest, Véronique-Isabelle; Nhan, Carol; Leboeuf, Rébecca; Tamilia, Michael; Mlynarek, Alex; Payne, Richard J.

doi:10.1177/0194599815617126

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…Another single paper assessed the connection with season and found that patients who underwent thyroidectomy in winter developed biochemical hypocalcaemia more frequently than those who had their operation in the summer months. 62…”

Section: Resultsmentioning

confidence: 99%

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: Resultsmentioning

confidence: 99%

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

2020

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“…Mascarella et al found significant differences in the rates of hypocalcaemia between the following months: winter (8.3%); spring (7.3%); summer (1.3%); autumn (3.5%). Thyroidectomy performed in winter was significantly associated with temporary hypocalcaemia in multivariable analysis (32).…”

Section: Vitamin Dmentioning

confidence: 94%

Incidence, prevalence and risk factors for post-surgical hypocalcaemia and hypoparathyroidism

Edafe

Balasubramanian

2017

Gland Surg.

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Hypocalcaemia following thyroid surgery is common and is associated with significant short and long term morbidity. Damage to or devascularisation of parathyroid glands is the predominant underlying mechanism; although other factors such as hungry bone syndrome may occasionally contribute to it in the immediate post-operative period. The reported incidence of post-surgical hypocalcaemia and/or hypoparathyroidism (PoSH) varies significantly in the literature; the variation thought to be at least partly due to differences in the definitions used. Figures on the prevalence of chronic or long term post-surgical hypocalcaemia in the population are unclear. Risk factors for PoSH have been extensively studied in recent years and may be classified into patient, disease and surgery related factors. Some risk factors are modifiable; but both modifiable and non-modifiable factors help in generating a risk profile that may be used to select patients for preventative measures and/or changes in surgical strategy. This narrative review discusses recent literature on the incidence, prevalence and risk factors for PoSH.

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“…Our previous survey study showed that a majority (57%) of surgeon members of the ATA and the International Association of Thyroid Surgeons who responded to the survey do not recommend checking vitamin D levels prior to thyroidectomy 20 . One of the factors that increased the likelihood for surgeons to check vitamin D levels was practicing in the Northeast region of the United States, which could be attributed to the increased risk of developing hypocalcaemia in areas with significant winter seasons 21 . Interestingly, there was no significant difference between surgeons practicing in the United States vs other countries, as was seen with endocrinologists.…”

Section: Discussionmentioning

confidence: 99%

“…20 One of the factors that increased the likelihood for surgeons to check vitamin D levels was practicing in the Northeast region of the United States, which could be attributed to the increased risk of developing hypocalcaemia in areas with significant winter seasons. 21 Interestingly, there was no significant difference between surgeons practicing in the United…”

Section: Ta B L E 1 Check Preoperative Vitamin D Levels To Predict Postoperative Hypocalcaemiamentioning

confidence: 99%

The use of vitamin D in preventing post‐thyroidectomy hypocalcemia: An endocrinologist survey study

Pinardo

Rubin

Hashemi

et al. 2020

Clinical Endocrinology

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Objective: To evaluate the use of preoperative vitamin D levels and postoperative vitamin D supplementation among endocrinologists for the prevention of post-thyroidectomy hypocalcaemia. Methods: Endocrinologist members of the American Thyroid Association (ATA) were contacted via email to complete a 21-question survey, which included both questions about demographic information, and preventing and managing postoperative hypocalcaemia after thyroidectomy. Univariate and multivariate analysis was performed to determine the respondents' use of preoperative vitamin D levels, dose and duration of preoperative vitamin D repletion, decision to delay surgery for low vitamin D levels in the case of a benign or malignant disease, and routine prescription of postoperative calcium or vitamin D supplementation. Results: 225 endocrinologists who were ATA members responded to the questionnaire. When compared to endocrinologists practicing in other countries, those that practice in the United States were 2.5 times more likely to check preoperative vitamin D levels (95% CI[1.404, 4.535], P = .002), significantly more likely to replete vitamin D deficient patients with high-dose vitamin D (ie ≥50K IU/week), 4.458 times more likely to prescribe prophylactic supplemental calcium (95% CI[2.446, 8.126]; P < .0001) and 3.48 more likely to prescribe supplemental vitamin D (95% CI [1.906, 6.355]; P < .0001). Endocrinologists who have been in practice for >10 years were also 1.915 times more likely to prescribe supplemental vitamin D (95% CI (1.080, 3.395); P = .0263). Physicians that treat >50 thyroidectomy cases/year were 2.083 more likely to recommend a vitamin D repletion duration of >1 month than those that treat ≤50 cases/year ([1.036, 4.190], P = .0395). Lastly, if the patient has low preoperative vitamin D levels, 47.05% of respondents chose to delay surgery in a benign disease, while only 11.61% of respondents would do so in a case of malignant disease. Conclusions: Approximately one-half of surveyed endocrinologists reported using preoperative vitamin D levels to assess a patient's risk for post-thyroidectomy | 599 PINARDO et Al.

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Seasonal Difference in Postthyroidectomy Hypocalcemia

Cited by 7 publications

References 17 publications

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

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

Incidence, prevalence and risk factors for post-surgical hypocalcaemia and hypoparathyroidism

The use of vitamin D in preventing post‐thyroidectomy hypocalcemia: An endocrinologist survey study

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