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Preoperative vitamin D deficiency increases hypocalcemia risk after thyroidectomy
The risks for hypocalcemia and prolonged hospital stay are increased in patients with preoperative vitamin D deficiency undergoing total thyroidectomy, study data show.
Mark R. Burge, MD, professor of medicine in the department of internal medicine/endocrinology at the University of New Mexico Health Sciences Center, and colleagues evaluated 30 adults who underwent total thyroidectomy at the University of New Mexico Hospital between 2005 and 2014 to determine the rates of hypocalcemia among patients with vitamin D deficiency (25-hydroxyvitamin D ≤ 20 ng/mL; n = 12) and patients without vitamin D deficiency (25-(OH)D > 20 ng/mL; n = 18).
Vitamin D repletion therapy was being administered to 33% of the deficiency group at the time of surgery, the researchers wrote.
The two groups did not differ significantly for the indication for surgery and rate of performing neck dissection and parathyroid autotransplantation.
The deficiency group had lower nadir postoperative ionized calcium concentrations (P = .04) and lower nadir phosphorus concentrations (P = .03) compared with vitamin D-sufficient group. Postoperative parathyroid hormone concentrations and the proportion of participants experiencing at least a 50% drop in postoperative parathyroid hormone concentrations were similar between the two groups, according to the data.
Postoperative complications occurred in 33% of the deficiency group and 17% of the vitamin D-sufficient group (P = .39). Hypocalcemia resulting in prolonged length of stay occurred in 75% of the deficiency group that experienced postoperative complications and 33% of the sufficiency group.
None of the sufficiency group required IV calcium therapy compared with three participants in the deficiency group (P = .054). The deficiency group had a longer hospital stay compared with the sufficiency group (P = .03).
“Preoperative vitamin D deficiency is associated with increased occurrence of postoperative hypocalcemia and a prolonged length of hospital stay following total thyroidectomy,” the researchers wrote. “Screening for [vitamin D deficiency] in all patients preoperatively, as well as aggressive treatment of patients with documented preoperative vitamin D deficiency, is indicated for all patients undergoing total thyroidectomy.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.