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Abstract
Objective:
To determine the frequency, pattern, and associated risk factors of calcium imbalance following thyroid surgery.
Methodology:
This prospective observational study was conducted at a tertiary care hospital over a period of 6 months. A total of 150 patients undergoing thyroid surgery were included through non-probability consecutive sampling. Serum calcium levels were measured preoperatively and postoperatively at 24, 48, and 72 hours. Hypocalcemia was defined as serum calcium <8.5 mg/dL. Data were analyzed using SPSS version26. Quantitative variables were expressed as mean ± standard deviation, while qualitative variables were presented as frequencies and percentages. Associations between risk factors and hypocalcemia were assessed using Chi-square/Fisher’s exact test. A p-value ≤ 0.05 was considered statistically significant. Frequencies were reported with 95% confidence intervals.
Results:
Out of 150 patients, 42 (28%; 95% CI: 21.0–35.8%) developed postoperative calcium imbalance. Transient hypocalcemia was observed in 36 (24%) patients, while permanent hypocalcemia occurred in 6 (4%). A significantly higher incidence of hypocalcemia was observed in patients undergoing total thyroidectomy compared to subtotal thyroidectomy (37.5% vs 17.1%, p=0.002). Parathyroid gland injury (57%, p=0.001), vitamin D deficiency (41%, p=0.004), and female gender (33%, p=0.03) were also significantly associated with postoperative hypocalcemia.
Conclusion:
Calcium imbalance is a common complication following thyroid surgery. Total thyroidectomy, parathyroid injury, and vitamin D deficiency are significant risk factors. Careful surgical technique and preoperative assessment can help reduce its incidence.