Post-thyroidectomy hypocalcemia, often due to hypoparathyroidism, is a common complication, and may require long-term management in some patients. Identifying risk factors is crucial for improving outcomes and reducing healthcare costs. This study aims to identify predictors of post-thyroidectomy hypocalcemia and its impact on recovery. This is a retrospective cohort study of 341 patients who underwent total or completion thyroidectomy from August 2022 to August 2024 at National University Hospital (NUH). The main outcome was post-thyroidectomy hypocalcemia (serum calcium <2.1 mmol/L within 24 h). Bivariate and multivariate logistic regressions were used to identify risk factors of post-thyroidectomy hypocalcemia and hypoparathyroidism. The incidence of post-thyroidectomy hypocalcemia was 13.8%. Patients with hypocalcemia had significantly longer hospital stays (3 days ± 3 days) compared to normocalcemic patients (2 days ± 2 days, p < 0.001). Surgery duration was longer in the hypocalcemia group (226 ± 100 min) than in the normocalcemia group (204.5 ± 78 min, p < 0.05). Multivariate analysis identified that incidental parathyroidectomy (OR = 2.194, (95%CI: 1.145, 4.203) p = 0.018) and postoperative hypoparathyroidism (OR = 2.210 (95%CI: 1.152,4.239); P = 0.017) were significant predictors. Patients with hypocalcemia were more likely to have a hospital stay of 3 days or more (OR 2.947 (95%CI: (1.568-5.540), p < 0.001), require vitamin D supplementation (OR = 4.72 (95%CI: (2.048-10.882), p = 0.001) and intravenous calcium gluconate (OR = 5.073 (95%CI: (2.174-11.84), p < 0.001). Postoperative hypocalcemia is significantly associated with extended surgery duration and an increase in length of stay for calcium restoration. Prompt identification and personalised calcium management of at-risk patients could help lower morbidity and reduce healthcare costs.
Teo et al. (Sun,) studied this question.
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