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DGDispatch
Risk of Hypocalcaemia After Thyroidectomy Linked to Preoperative Thyrotoxicosis: Presented at AHNS
By Arushi Sinha
SAN FRANCISCO -- July 24, 2008 -- The risk of hypocalcaemia in the postoperative setting is significantly correlated to an initial diagnosis of thyrotoxicosis in patients undergoing complete thyroidectomy, according to research presented here at the American Head and Neck Society (AHNS) 7th International Conference on Head and Neck Cancer.
According to the researchers, hypocalcaemia occurs often in patients who have undergone complete thyroidectomy but may be more frequent in patients diagnosed with thyrotoxicosis.
"Hypocalcaemia often occurs in cases of thyrotoxicosis, thyroid cancer, and goitre," explained study presenter Anurag Jain, FRCS, Institute of Head and Neck Studies and Education, University Hospital Coventry, Coventry, United Kingdom, in a poster presentation on July 22.
Dr. Jain and colleagues conducted their study to examine the potential link between complete thyroidectomy and postoperative hypocalcaemia. They recruited 95 patients who underwent total thyroidectomy and determined the incidence of postoperative hypercalcaemia according to the patient's age, thyroid gland size, and initial diagnosis. For the purposes of this study, hypercalcaemia was defined as serum calcium levels <2.1 mmol/L.
Results showed that 22.1% of 95 patients were diagnosed with thyrotoxicosis, 32.6% were diagnosed with thyroid carcinoma, and 45.2% had multinodal goitre.
Postoperative hypocalcaemia occurred in 52.3% of patients with thyrotoxicosis, 70.9% of patients with thyroid carcinoma, and 65.1% of patients with goitre. About one-third (32.6%) of these patients required calcium replacement therapy: 47.6% of thyrotoxicosis patients, 29% thyroid carcinoma patients, and 27.9% goitre patients.
After eliminating such factors as parathormone levels and vitamin D deficiency, the researchers determined that thyrotoxicity was the leading indicator of hypocalcaemia as a result of surgery in 23.8% of patients. By comparison, hypocalcaemia was linked to thyroid carcinoma surgery in 16.1% of patients and to multinodular goitre surgery in 11.6% of patients.
The researchers concluded that the rate of hypocalcaemia after surgery is higher among patients diagnosed with thyrotoxicosis, especially when compared with those patients with multinodal goitre (23.8% vs 16.1%, respectively). In this study, about half of patients with hypocalcaemia required calcium replacement supplementation.
"With greater awareness of this condition prior to surgery, there can be better management of it postoperatively, and may even pre-empt the incidence of hypocalcaemia," Dr. Jain concluded.
[Presentation title: Does the Indication for Surgery Affect the Incidence of Hypocalcaemia Post Thyroid Surgery? Abstract P746]
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