Vitamin D and Risk of Postoperative Hypocalcemia A

Authors: Tomas P Griffin Matthew S Murphy Patrick Sheahan

Publish Date: 2014/04/01

Volume: 140, Issue: 4, Pages: 346-351

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Abstract

Importance  Transient hypocalcemia is a wellrecognized occurrence after total thyroidectomy It has been hypothesized that underlying vitamin D deficiency may increase the risk of this complication although to date there are few data in the literature supporting this hypothesisDesign Setting and Participants  We performed a retrospective review of a prospectively maintained database of thyroidectomies from November 1 2009 through September 30 2012 at an academic teaching hospital The study included 121 patients with available vitamin D levels undergoing total or completion thyroidectomy Patients with preexisting hypercalcemia or hyperparathyroidism were excludedInterventions  All patients underwent total removal of all thyroid tissue by a capsular dissection technique Routine calcium or vitamin D supplementation was not administered Biochemical hypocalcemia was defined as any single postoperative corrected calcium level less than 80 mg/dL to convert to millimoles per liter multiply by 025 and symptomatic hypocalcemia as any symptoms of hypocalcemiaMain Outcomes and Measures  Outcome measures were incidence of postoperative hypocalcemia and association with vitamin D levels A multivariate analysis was performed to study the effect of other variables including performance of central neck dissection incidental parathyroidectomy and hyperthyroidism on the incidence of postoperative hypocalcemiaResults  The incidence of transient biochemical hypocalcemia was 24 n = 29/121 There was no correlation between vitamin D levels and risk of postoperative hypocalcemia On univariate analysis performance of concomitant central compartment neck dissection revealed an increased risk of hypocalcemia P = 06 but this finding was not significant on multivariate analysis

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