Predictors of hypocalcaemia and hypoparathyroidism in patients undergoing thyroidectomy for benign and malignant pathologies.

Objective: To analyse the risk factors of hypoparathyroidism and hypocalcaemia after total thyroidectomy.

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

Results: A total of 300 patients who underwent total thyroidectomy were enroled. The median age of the study population was 41 years, and 70% were females. Histopathological examination showed that 80.3% had thyroid cancer. The incidence of postoperative transient hypoparathyroidism was 26.7%, while postoperative transient hypocalcaemia was 12.3%. Multivariate analysis showed that the 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 the 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 hypocalcaemia.

Conclusion: Hypoparathyroidism and hypocalcaemia after thyroid surgery are common, and most of them are transient. The independent predictors of hypoparathyroidism and hypocalcaemia differ. Hypoparathyroidism appears to be a better predictor for patients who will develop postoperative hypocalcaemia.