Clinical Factors Associated with Immediate Postoperative Hypocalcemia After Total Thyroidectomy at the Philippine General Hospital: A Case Series with Planned Data Collection
DOI:
https://doi.org/10.32412/pjohns.v41i1.2663Keywords:
hypocalcemia, thyroidectomy, clinical factors, incidence, postoperative complications, case series, tertiary hospital, female sexAbstract
Objective: To identify clinical factors, may it be patient, procedure, or tumor-related, associated with hypocalcemia post-thyroidectomy
Methods:
Design: Case Series with Planned Data Collection
Setting: Tertiary National University Hospital
Participants: Total enumeration reviewed records of 664 patients aged 19 years old and above, previously admitted under the Philippine General Hospital Department of Otolaryngology – Head and Neck Surgery from 2019 to 2023 who underwent total thyroidectomy (including completion thyroidectomy and those with neck dissection) and had serum calcium determination done both 6 and 24 hours post-operation. Cumulative incidence of hypocalcemia was determined, and patient-related, procedure-related, and tumor-related factors were investigated, with multivariable logistic regression analysis performed to identify the association between clinical factors and postoperative hypocalcemia.
Results: The cumulative incidence of hypocalcemia at 6 hours and 24 hours post-operation was 28.92% (95%CI: 25.49%–32.53%) and 19.49% (95%CI: 16.01%–23.36%), respectively. The clinical factors with notable increased odds for postoperative hypocalcemia were female sex (adjusted OR: 3.5; 95%CI: 1.2623–9.6362), total thyroidectomy as type of surgery (adjusted OR: 0.7; 95%CI: 0.2905–1.6805; adjusted OR: 0.8; 95%CI: 0.2616–2.6670), histopathologic type of papillary thyroid carcinoma (adjusted OR: 1.4; 95%CI: 0.8949–2.0719; adjusted OR: 1.6, 95%CI: 0.8985 2.7771), and the presence of parathyroid tissue in the excised specimen (adjusted OR: 1.2; 95%CI: 0.7436–1.9002; adjusted OR: 1.6; 95%CI: 0.8406–2.9496). The only statistically significant factor out of all those investigated was female sex.
Conclusion: The only statistically significant clinical factor associated with hypocalcemia in our study was female sex, with total thyroidectomy as type of surgery, histopathologic type of papillary thyroid carcinoma, and presence of parathyroid tissue in the excised specimen as other factors noted with increased odds for hypocalcemia.
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