A Meta-Analysis of Risk Factors for Transient and Permanent Hypocalcemia After Total Thyroidectomy

Overview

Journal Front Oncol

Specialty Oncology

Date 2021 Mar 15

PMID 33718114

Citations 17

Authors

Yuan Qin

Wei Sun

Zhihong Wang

Wenwu Dong

Liang He

Ting Zhang

Hao Zhang

Affiliations

Soon will be listed here.

Abstract

Background: As hypocalcemia is the most common complication of total thyroidectomy, identifying its risk factors should guide prevention and management. The purpose of this study was to determine the risk factors for postthyroidectomy hypocalcemia.

Methods: We searched PubMed, Web of Science and EMBASE through January 31, 2019, and assessed study quality using the Newcastle-Ottawa Scale.

Results: Fifty studies with 22,940 patients met the inclusion criteria, of which 24.92% (5716/22,940) had transient hypocalcemia and 1.96% (232/11,808) had permanent hypocalcemia. Significant ( < 0.05) predictors of transient hypocalcemia were: younger age, female, parathyroid autotransplantation (PA), inadvertent parathyroid excision (IPE), Graves' disease (GD), thyroid cancer, central lymph node dissection, preoperative severe Vitamin D deficiency, preoperative Vitamin D deficiency and a lower postoperative 24 h parathyroid hormone (PTH) level. Preoperative magnesium, preoperative PTH and Hashimoto's thyroiditis were not significant predictors of transient hypocalcemia. IPE, GD, and thyroid cancer were associated with an increased rate of permanent hypocalcemia, but gender and PA did not predict permanent hypocalcemia.

Conclusion: Important risk factors for transient and permanent hypocalcemia were identified. However, given the limited sample size and heterogeneity of this meta-analysis, further studies are required to confirm our preliminary findings.

Citing Articles

The effect of preoperative vitamin D values on hypocalcemia after total thyroidectomy.

Qanbar M, Soylu S, Teksoz S Turk J Surg. 2025; 40(4):296-302.

PMID: 39980640 PMC: 11831996. DOI: 10.47717/turkjsurg.2024.6219.

Ionized calcium and PTH as predictors of hypoparathyroidism following total thyroidectomy.

Sanchez-Canteli M, Pasaron-Canga M, Riestra-Fermandez M, Gutierrez-Buey G, Martinez-Gonzalez P, Fernandez-Morais R Eur Arch Otorhinolaryngol. 2025; .

PMID: 39849077 DOI: 10.1007/s00405-025-09205-2.

Predictors of hypocalcaemia and hypoparathyroidism in patients undergoing thyroidectomy for benign and malignant pathologies.

Johns Lalitha J, Ramalingam N, Rajan R, Riju J, Paulose A, Michael R Endocr Oncol. 2024; 4(1):e240022.

PMID: 39649119 PMC: 11623251. DOI: 10.1530/EO-24-0022.

The outcomes of parathyroid gland autotransplantation during thyroid surgery: a systematic review, meta-analysis and trial sequential analysis.

Koimtzis G, Stefanopoulos L, Geropoulos G, Papavramidis T Endocrine. 2024; 87(1):27-38.

PMID: 39182014 DOI: 10.1007/s12020-024-04011-y.

Artificial neural network to predict post-operative hypocalcemia following total thyroidectomy.

Rao K, Arora R, Rajguru R, Nagarkar N Indian J Otolaryngol Head Neck Surg. 2024; 76(4):3094-3102.

PMID: 39130277 PMC: 11306864. DOI: 10.1007/s12070-024-04608-9.

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