Abstract: Background: Hypocalcemia after thyroid surgery is a common complication that can cause severe short- and long-term morbidity. The goal of this study was to see how often post-thyroidectomy hypocalcaemia (defined as a corrected calcium of less than 2.1 mmol/l) was and what factors could predict it in a tertiary surgical center.
Aims: The aim of present study was to assess the incidence of post thyroidectomy hypocalcemia and factors which might play a role in its occurrence.
Materials and Methods: The present prospective study was conducted in department of general surgery in 40 patients who had their thyroids removed bilaterally were studied. The research was conducted from March 2017 to February 2019. Serum calcium estimation was used to determine the incidence of hypocalcemia in the immediate post-operative period, 4 hours, and 24 hours following surgery, and on the 5th post-operative day. Pre-operative and post-operative serum calcium levels, clinical manifestations, and disease type all patients were examined.
Results: Mean age of the patients was 48.2±14.90 years with a range of 21-70 years. Maximum number of patients had colloid goitre on FNAC i.e., 18 (45%) followed by atypical cells s/o malignancy in 9 (22.5%) patients. In 32 (80%) patients, total thyroidectomy was performed and in 8 (20 %) patients subtotal thyroidectomy was performed. Mean serum calcium preoperatively was 9.0±0.2 and when it was compared with serum calcium level in immediate postoperative, 4 hours after surgery, 24 hours after surgery and 5 days after surgery, it showed a significant difference (p<0.001). The maximum level of hypocalcemia was noted. Total incidence of hypocalcemia as 65% that means 26 patients out of 40 developed hypocalcemia. Out of these 26 patients, 12 patients are of colloid goitre, 7 each in papillary carcinoma and multinodular goitre. Incidence of hyocalcemia is high in carcinoma.
Conclusions: The incidence of post-thyroidectomy hypocalcaemia was underestimated by 6% when only POD1 measurements were considered. The timing of measurement on POD1 has an impact on the incidence of post-thyroidectomy hypocalcaemia.
