Incidence and Risk Factors for Post-Thyroidectomy Hypocalcemia: A National Study from Saudi Arabia

Objectives: Post-thyroidectomy hypocalcemia is the leading cause of post-thyroidectomy hospitalization, adversely affecting patient quality of life. The current study sought to determine the incidence of post-thyroidectomy hypocalcemia, identify risk factors and their clinical significance, and provide an overview of the incidence in different Saudi Arabian cities. Methods: This retrospective analysis included all patients who underwent thyroidectomies at King Salman Armed Forces Hospital Northwestern Region, Tabuk, Saudi Arabia between 2015 and 2021 and had available pre- and post-operative calcium levels and clinical, surgical, and pathological data. Various risk factors were evaluated using binary logistic regression to determine their impact on the development of post-thyroidectomy hypocalcemia. Results: A total of 153 patients were enrolled, and most (n = 128, 83.7%) were women; 88 patients (57.5%) received a malignant diagnosis. The overall incidence of post-thyroidectomy hypocalcemia was 70.6%. In the multivariate logistic regression analysis, female gender (adjusted odds ratio [ORA] = 2.9; 95% confidence interval [CI], 1.0–7.6), the presence of diabetes mellitus (ORA = 4.9; 95% CI, 1.2–20.5), and the failure to identify the parathyroid glands in the operative report (ORA = 2.9; 95% CI, 1.2–6.7) significantly correlated with a higher risk of post-thyroidectomy hypocalcemia. Redo surgery was the sole factor significantly correlated with permanent hypocalcemia (p = 0.048). Conclusion: Post-thyroidectomy hypocalcemia is a serious condition that should be evaluated at each center to provide patients with accurate risk assessments prior to surgery. Further studies are required to overcome this surgically challenging condition.