Abstract
Purpose
Transient hypocalcaemia after thyroid surgery and its possible predictors have not been extensively described in the elderly. This study aimed to establish the frequency of postsurgical transient hypocalcaemia according to the extent of thyroid surgery in older adults and to assess mineral metabolism biochemical parameters as its predictors.
Methods
All patients ≥60 years undergoing thyroid surgery were prospectively included. Type of surgery (hemithyroidectomy(HT) or total thyroidectomy(TT)); and preoperative 25OH Vitamin D (25OHD) and pre and 6 (only TT), 24 h and 6 months postsurgical serum levels of calcium, magnesium, phosphate and parathormone (PTH) were considered. Postsurgical hypoparathyroidism (hPTpost) was defined at PTH levels ≤11 pg/mL.
Results
Out of 46 patients (87% female), age (mean ± SD) 70.1 ± 6.2 years, 24 h postsurgical hypocalcaemia was found in ten patients (22%). In 25 (54%) TT patients, 36% and 16% had postsurgical hypocalcaemia at 6 and 24 h respectively; 28% hPTpost but no definitive hPT was recorded and 44% had 25OHD deficiency. Lower 24 h magnesium levels were found in those TT patients with 24 h hypocalcaemia (1.6 ± 0.1 vs 1.9 ± 0.1 mg/dL (p = 0.005)). Among 21 (46%) HT patients, 28.6% had 24 h postsurgical hypocalcaemia; 9.5% had hPTpost. A positive correlation was observed between preoperative 25OHD and 24 h calcaemia (r:0.51,p = 0.02). 43% of the patients were 25OHD deficient, in whom 55% had 24 h hypocalcaemia vs only 9% in the 25OHD sufficient group (p = 0.049).
Conclusion
Postsurgical hypocalcaemia was common in elderly thyroidectomized patients. After TT, lower magnesium levels were found in those patients with 24 h hypocalcaemia. In the HT group, preoperative 25OHD deficiency predicted lower postsurgical calcium levels.
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Data availability
All data and material was collected at Dr. Cesar Milstein Care Unit, Buenos Aires.
Change history
26 November 2021
A Correction to this paper has been published: https://doi.org/10.1007/s12020-021-02943-3
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Acknowledgements
We would like to thank the Endocrine and Surgery residents of Dr. Cesar Milstein Unit Care for their support in the follow-up of patients and collection of data.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [B.M.P., S.N., M.A.Y., L.M., S.L., S.C., M.T., F.C., F.M.P. and B.G.]. The first draft of the paper was written by [B.M.P., M.E., S.C. and B.G.] and all authors commented on previous versions of the paper. All authors read and approved the final paper.
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Barbier, M.P., Mingote, E., Sforza, N. et al. Incidence and predictive factors of postoperative hypocalcaemia according to type of thyroid surgery in older adults. Endocrine 75, 276–283 (2022). https://doi.org/10.1007/s12020-021-02840-9
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DOI: https://doi.org/10.1007/s12020-021-02840-9