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  • Author: Natarajan Ramalingam x
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Jino Johns Lalitha J Lalitha , Head and neck surgery, Christian Medical College and Hospital Vellore, Vellore, India

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Natarajan Ramalingam N Ramalingam , Head and neck surgery, Christian Medical College and Hospital Vellore, Vellore, India

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Remya Rajan R Rajan , Endocrinology, Christian Medical College and Hospital Vellore, Vellore, India

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Jeyashanth Riju J Riju, Head and Neck Surgery, Christian Medical College Vellore, Vellore, India

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Antony Abraham Paulose A Paulose , Head and neck surgery, Christian Medical College and Hospital Vellore, Vellore, India

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Rajiv Charles Michael R Michael, Head and neck surgery, Christian Medical College and Hospital Vellore, Vellore, India

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Amit Jiwan Tirkey A Tirkey , Head and neck surgery, Christian Medical College and Hospital Vellore, Vellore, India

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Twisha Adhikari T Adhikari , Pathology, Christian Medical College and Hospital Vellore, Vellore, India

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Shalini Sahu S Sahu , Radiodiagnosis, Christian Medical College and Hospital Vellore, Vellore, India

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R Nagayazhini R Nagayazhini , Medical Biostatistics, Christian Medical College and Hospital Vellore, Vellore, India

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Objective

To analyse the risk factors of hypoparathyroidism and hypocalcemia after total thyroidectomy.

Methods

Clinical data of patients who underwent total thyroidectomy in a tertiary care hospital from the southern part of India was collected retrospectively from January 2021 to May 2023. Multivariate logistic regression was used to analyse the risk factors associated with transient hypoparathyroidism and hypocalcemia separately.

Results

A total of 300 patients who underwent total thyroidectomy were enrolled. The median age of the study population was 41 years, and 70% were females. Histopathological examination showed 80.3% had thyroid cancer. The incidence of postoperative transient hypoparathyroidism was 26.7%, while postoperative transient hypocalcemia was 12.3%. Multivariate analysis showed that presence of hypothyroidism before surgery (OR 3.230,95%CI:1.368–7.624,p=0.007), performing central compartment neck dissection (CCND) (OR 2.196,95%CI:1.133-4.257,p=0.02) and parathyroid gland in surgical specimen (OR 5.547, 95%CI:3.065–10.036,p<0.0001) were independent predictors of postoperative transient hypoparathyroidism. Female gender (OR 2.689,95%CI:1.049-6.895,p= 0.039), presence of parathyroid in the surgical specimen (OR 1.067,95%CI:0.367-8.438,p=0.004) and performing CCND (OR 2.192,95%CI:0.990-4.850,p=0.05) were independent predictors of postoperative transient hypocalcemia.

Conclusion

Hypoparathyroidism and hypocalcemia after thyroid surgery are common, and most of them are transient. Independent predictors of hypoparathyroidism and hypocalcemia differs. Hypoparathyroidism appears to be a better predictor for patients who will develop postoperative hypocalcemia.

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