Prevalence and Associated Factors of Post-ThyroidectomyHypocalemia in Patients who UnderwentThyroidectomy in Tikur Anbessa Specialized Hospital:A Retrospective Stydy.
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Date
2025-07
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Addis Ababa University
Abstract
Background: Thyroid disease is a common disorder of endocrine system globally. Thyroidectomy is one of the most common surgeries performed worldwide. Post-thyroidectomy hypocalcemia is one of the most dreaded complications following thyroidectomy, which can lead to considerable morbidity and deleterious effect in the quality of life of affected patients. Despite advancements in surgical techniques and perioperative care, the incidence of hypocalcemia remains a considerable challenge. It primarily occurs due to inadvertent damage or removal of the parathyroid glands during surgery, leading to a transient or permanent decrease in serum calcium levels.There is inadequate information regarding the prevalence and associated factors of post-thyroidectomy hypocalcemia in the study area and this study is intended to investigate it.
Objective: To determine the prevalence of Post-thyroidectomy hypocalcemia and associated factors among patients who underwent total and completion thyroidectomy with or without central/lateral neck dissections in Tikur Anbessa Specialized Hospital (TASH), from January 2021 to June 2024.
Methods and Materials: A retrospective study design was employed to conduct this study. Secondary data was collected from patient medical record by using structured checklist checked for its completeness, entered, edited, cleaned and analyzed by SPSS version 25. The study period was from May 2025 to June 2025.
Result: The result showed the overall prevalence of post-thyroidectomy hypocalcemia was 32.6% with prevalence of post-thyroidectomy transient hypocalcemia 25.7%, and permanent hypocalcemia 6.9%. The study revealed that the rate of post-thyroidectomy hypocalcemia varied with type of thyroidectomy and pathologic diagnosis. The rate was higher (39.3%) for TT with CND and/or MRND than TT and completion thyroidectomy alone,which was 31.0% and 31.3% respectively. This study also showed that patients with intraoperative identification of 4 PT glands were at higher risk of developing post-thyroidectomy hypocalcemia than those patients in which PT gland identification was not achieved with AOR=2.93(1.28,6.71)(p=0.011). This study showed that out of 28 patients who stayed in the hospital for >3 days to week,19(67.9%) were those with post-thyroidectomy hypocalcemia and out of 11 patients who stayed in the hospital for >1 week,9(81.8%) were those with post-thyroidectomy
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hypocalcemia,showing that post-thyroidectomy hypocalcemia is associated with prolonged hospitalization.
There was no statistically significant association between post-thyroidectomy hypocalcemia and age, sex,type of thyroid disease, or pathologic diagnosis in this study.
Conclusion and Recommendation:
This study highlighted that post-thyroidectomy hypocalcemia is prevalent among 32.6% of patients who underwent total and completion thyroidectomy with or without central and/or lateral neck dissections.
The study also showed excessive dissection during thyroidectomy to identify PT glands may compromise their blood supply and may predispose patients to postoperative hypocalcemia.
Post-thyroidectomy hypocalcemia was associated with prolonged postoperative hospital stay in this study.
The study also revealed the effect of calcium and vitamin D supplementation on the reduction of transient post-thyroidectomy hypocalcemia.
Therefore,routine supplementation of calcium and vitamin D for patients after total thyroidectomy and completion thyroidectomy should be encouraged practice in endocrine and breast surgery unit. The unit has to make measurement of postoperative serum calcium and preoperative vitamin D a routine practice. Additionally the unit has to stick to the practice of capsular dissection technique with minimal manipulation around PT glands during thyroidectomy. The hospital administration has to equip the laboratories in the hospital with biochemical tests such as serum vitamin D,serum calcium and iPTH. Finally,for strong and reliable results,undergoing prospective multicenter study with larger sample size is recommended.
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Keywords
post-thyroidectomy hypocalcemia, total thyroidectomy, serum calcium