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Predictors of Post-Operative Hypocalcemia after Thyroidectomy at an Apex Care Centre in North-Western India: A Prospective Cohort Study
Thyroid ; 32(Supplement 1):A163, 2022.
Article in English | EMBASE | ID: covidwho-2097286
ABSTRACT

Aim:

Post operative hypocalcaemia is the most frequent complication following thyroidectomy. It can be permanent or transient hypoparathyroidism of which the incidence of permanent hypoparathyroidism is less than 3 %. This study aimed to evaluate and identify the predictors of postoperative hypocalcaemia in patients undergoing thyroidectomy.

Methodology:

A prospective cohort study was conducted on 52 patients at an apex care institute. Preoperative testing for serum calcium, Parathormone (PTH) and Vitamin D were done on the day of surgery. These patients were subjected to surgery as per standard protocol. Postoperative testing for PTH was done 24 hours after surgery and serum calcium on day 0 and 1. All patients were assessed clinically for signs and symptoms of hypocalcemia till 48 hours post operatively and they were correlated with biochemical parameters and season in which surgery was performed. Result(s) A total of 52 patients were operated in our institute over a period of 18 months in the midst of COVID 19 outbreaks. Both hemi thyroidectomy (40) and total thyroidectomy (12) patients were included in the study. One significant finding was the low levels of preoperative Vitamin D values among 90% of the subjects. Out of the 52 patients, 12 underwent total thyroidectomy and 40 underwent hemi thyroidectomy as per standard protocols. 54% of the patients of total thyroidectomy and 52% of the patients of hemi thyroidectomy developed clinical as well as biochemical hypocalcemia over a period of 48 hours and were managed as per standard protocol. 38% of the patients were having low calcium values preoperatively and a statistically significant correlation was found between preoperative low calcium value and development of postoperative clinical hypocalcemia (P value 0.001). There was no statistically significant correlation between Pre operative Vitamin D level and season of surgery with postoperative clinical hypocalcemia. Conclusion(s) All patients being planned for surgery, whether it is total or hemi thyroidectomy should undergo preoperative serum calcium evaluation and necessary correction if required, since preoperative low calcium is a clear predictor of post thyroidectomy clinical hypocalcemia. Further studies are required to correlate relation between Vit. D level and postoperative hypocalcemia.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Thyroid Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Thyroid Year: 2022 Document Type: Article