The Southwestern Surgical CongressVitamin D deficiency does not increase the rate of postoperative hypocalcemia after thyroidectomy
Section snippets
Patients
Approval for this study was granted by the Colorado Multiple Institutional Review Board (protocol 10-1477). A retrospective analysis was performed of 152 patients undergoing near-total thyroidectomy between 2007 and 2011 for whom a 25-hydroxyvitamin D level was drawn at the preoperative appointment. All surgeries were performed at the University of Colorado Hospital by 1 of 2 experienced endocrine surgeons (RCM or CDR). Patients were excluded if they had undergone previous thyroid or
Results
A total of 152 patients were included in the study. Seventy-eight patients (51%) had a preoperative vitamin D level <30 ng/mL, and 31 (20%) had a level <20 ng/mL. Table 1 depicts the demographic, preoperative, and operative characteristics in each group. Groups were similar in age, sex, and whether the preoperative diagnosis was cancer or a suspicion for cancer. Compared with the control groups, body mass index was higher in those with a vitamin D level <30 ng/mL (29.6 kg/m2 ± 7.4 kg/m2 vs 26.4
Comments
Hypocalcemia is the most frequent complication after thyroidectomy.4, 18 Despite the fact that hypocalcemia is most commonly asymptomatic and transient, it can result in the need for additional medications, an increased length of stay, and readmissions, all of which are inconvenient and costly to the patient and health care system.1 Thus, the identification of a preoperative risk factor that could be modified to lower the risk of post-thyroidectomy hypocalcemia would be of great benefit.
Conclusions
Vitamin D deficiency was common in our population of patients undergoing thyroidectomy; however, it was not associated with an increased risk of postoperative hypocalcemia. Previous studies on this topic have reported contradictory findings, and we believe that a larger, prospective study is warranted to determine whether vitamin D deficiency is associated with post-thyroidectomy hypocalcemia.
References (24)
- et al.
The impact of age, vitamin D(3) level, and incidental parathyroidectomy on postoperative hypocalcemia after total or near total thyroidectomy
Am J Surg
(2009) - et al.
Cost savings associated with post-thyroidectomy parathyroid hormone levels
Otolaryngol Head Neck Surg
(2008) - et al.
Determinants of postoperative hypocalcemia in vitamin D-deficient Graves' patients after total thyroidectomy
Am J Surg
(2011) - et al.
Morbidity of thyroid surgery
Am J Surg
(1998) - et al.
The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients
Surgery
(2003) - et al.
Clinical aspects of early and late hypocalcaemia afterthyroid surgery
Eur J Surg Oncol
(2000) - et al.
Preoperative vitamin D deficiency predicts postoperative hypocalcemia after total thyroidectomy
World J Surg
(2011) - et al.
Complications of thyroid surgery: how to avoid Them, how to manage Them, and observations on their possible effect on the whole patient
World J Surg
(2000) - et al.
Hypocalcemia following thyroidectomy: incidence and prediction of outcome
World J Surg
(1998) - et al.
Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years
World J Surg
(2004)