Frequency of Hypocalcaemia following total Thyroidectomy

Abstract

Background: The most common post-thyroidectomy complication is hypocalcaemia. It could be permanent or transitory. Permanent hypocalcaemia has a prevalence of 0-13% and transient hypocalcaemia has a prevalence of 1-6%. Aim: The study objective was to ascertain the prevalence of postoperative hypocalcaemia in patients following total thyroidectomy. Materials and Methods: This cross-sectional study was carried out on 84 thyroid patients who underwent total thyroidectomy in the surgical department of HBS General Hospital, Islamabad for period of nine months during from September 2020 to May 2021. Patients within the age range of 15-69 years and had indicated thyroidectomy caused by carcinoma thyroid, multinodular goiter, and recurrent goiter were enrolled. Inform consent was obtained from each participant. Ethical approval was taken from the institutional ethical committee. Thyroid profile and serum calcium were done for a routine investigation. Serum calcium levels were measured 24 hours, 48 hours, and 7 days after total thyroidectomy. Signs and symptoms in hypocalcaemia patients were recorded on a proforma. Patients with hypocalcaemia were followed for six months. SPSS version 20 was used for data analysis. Results: The mean age of the patients was 46.7 ± 4.6 years with an age range of 16 to 69 years. Of the total 84 patients, 38 (45.2%) underwent total thyroidectomy and 46 (54.8%) underwent a complete thyroidectomy. The prevalence of male and female patients was 22 (26.2%) and 62 (73.8%) respectively. Malignant and benign were present in 71 (84.5%) and 13 (15.5%) respectively. Of the total 84 patients, 68 (81%) developed hypocalcaemia. Out of 68 hypocalcaemia patients, 29 (42.6%) and 39 (57.4%) were from the benign and malignant groups respectively. Conclusion: Postoperatively hypocalcaemia was prevalent following thyroidectomy. Malignant patients (84.5%) were more prevalent compared to benign patients (15.5%) after total thyroidectomy. Careful surgical procedures, parathyroid gland vascularity preservation, and identification are critical in preventing hypocalcaemia following total thyroidectomy. Keywords: Hypocalcaemia; Total thyroidectomy; Complete Thyroidectomy