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      Hypocalcemia following total and subtotal thyroidectomy and associated factors

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          Abstract

          Background

          Thyroidectomy is one of the common endocrinological surgeries for the treatment of thyroid disorders. Hypocalcemia is the potential complication after thyroidectomy, where is persistency can lead to serious systemic effects. The aim of this study is to evaluate the incidence of hypocalcemia in thyroidectomy patients.

          Methods

          In this cross-sectional study, patients referred to (XXX) for thyroidectomy from 2019 to 2020 were enrolled. Preoperative serum calcium and postoperative 24- and 48-h calcium levels were evaluated in these patients. Demographic data (sex and gender), calcium levels, type of thyroidectomy and duration of surgery was recorded for all the patients. SPSS v22 was used for statistical analysis. P < 0.05 was considered as statistically significant.

          Results

          Of 143 patients included in the study, the mean age was 49.7 ± 10.9 years and 61.5% were females and 38.5% were males. 49% patients had hypocalcemia in the first 24 hours after surgery and 63.6% following 48 hours of the surgery. The difference in calcium levels at three intervals were statistically significant, p = 0.001. The incidence of hypocalcemia was significantly more in women at 48 postoperative hours, p = 0.025. The age and duration of surgery was not significantly correlated with hypocalcemia, p > 0.05, whereas, patients who underwent total thyroidectomy had greater incidence of hypocalcemia 24 hours after the surgery, p = 0.021.

          Conclusions

          The incidence of hypocalcemia is greater in total thyroidectomy and female patients. Our study did not report significant correlation between duration of the surgery and age of the patients.

          Highlights

          • Thyroidectomy is one of the endocrinological surgeries for the treatment of thyroid disorders.

          • Hypocalcemia is the complication after thyroidectomy, can lead to serious systemic effects.

          • The incidence of hypocalcemia is greater in total thyroidectomy and female patients.

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          Most cited references22

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          STROCSS 2019 Guideline: Strengthening the reporting of cohort studies in surgery

          The STROCSS guideline was developed in 2017 to improve the reporting quality of observational studies in surgery. Building on its impact and usefulness, we sought to update the guidelines two years after its publication.
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            Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients.

            During recent years, more radical surgery for thyroid disease, i.e., total instead of subtotal resection, has been evident. Results following this strategy on national levels are scarce. From 2004 to 2006, 26 Scandinavian Departments registered 3,660 thyroid operations in a database. Risk factors for complications were analyzed with multiple logistic regression. After thyroidectomy, re-bleeding occurred in 2.1% and was associated with older age (OR 1.04; p < 0.0001) and male gender (OR 1.90; p = 0.014). Postoperative infection occurred in 1.6% and associated with lymph node operation (OR 8.18; p < 0.0001). Postoperative unilateral paresis of the recurrent laryngeal nerve was diagnosed 3.9% and bilateral paresis in 0.2%. Unilateral paresis was associated with older age, intrathoracic goiter, thyreotoxicosis, and if routine laryngoscopy was practiced (OR 1.92; p = 0.0002). After 6 months, the incidence of nerve paresis was 0.97%. After bilateral thyroid surgery (n = 1,648), hypocalcaemia treated with vitamin D analogue occurred in 9.9% of the patients at the first follow-up and in 4.4% after 6 months. Complications to thyroid surgery are not uncommon. The high frequency of hypocalcaemia treated with vitamin D after 6 months is a cause of concern.
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              Systematic review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia.

              Hypocalcaemia is common after thyroidectomy. Accurate prediction and appropriate management may help reduce morbidity and hospital stay. The aim of this study was to perform a systematic literature review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia.
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                Author and article information

                Contributors
                Journal
                Ann Med Surg (Lond)
                Ann Med Surg (Lond)
                Annals of Medicine and Surgery
                Elsevier
                2049-0801
                25 May 2021
                June 2021
                25 May 2021
                : 66
                : 102417
                Affiliations
                [a ]Department of Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
                [b ]Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
                [c ]Department of Internal Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
                Author notes
                []Corresponding author. Lorestan University of Medical Sciences, Lorestan Province, Khorramabad, A81, Iran. Tel.: +066 3330 0661/+9132866477. md.azadbakht.s@ 123456gmail.com
                Article
                S2049-0801(21)00367-8 102417
                10.1016/j.amsu.2021.102417
                8178078
                34136209
                1f44e8a6-c129-4cc6-bd3c-efdeb5b4acf4
                © 2021 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 30 April 2021
                : 15 May 2021
                : 16 May 2021
                Categories
                Cross-sectional Study

                thyroidectomy,endocrinological,hypocalcemia,subtotal,surgery

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