Assessment of Effect of Preoperative Vitamin D Deficiency on Postoperative Hypocalcemia after Total Thyroidectomy, A Prospective Study

• Published in: QJM : An International Journal of Medicine 2020-03, Vol.113 (Supplement_1)
• Main Authors: Farahat, M S, Omran, H M, Abbas, R F, Ghida, A A A
• Format: Article
• Language: English
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcaa050.045

Abstract Background One-day surgeries are routinely performed for hemithyroidectomy, but hospital stay duration is more controversial after total thyroidectomy due to postoperative, potentially life-threatening complications. Aim of the Work The aim of this study is to assess the effect of pre-operative vitamin D3 deficiency on post thyroidectomy hypocalcemia. Patients and Methods Type of Study: This was a prospective cohort study which included 60 Egyptian patients for whom total thyroidectomy had been performed. Study Setting: Patients were recruited from general surgery department at Kafr Elshiekh University Hospital and Ain Shams University Hospital. Study Period: The study duration was form April 2018 to October 2018. Results The main findings of the current study as regards to calcium was that the mean preoperative level of calcium was 9.61 ± 0.48 mg/dl, the lowest level of postoperative calcium was detected after 48 hours (9.03 ± 0.73) and the highest postoperative level was measured 12 hours after the operation. With respect to relation between calcium and preoperative vitamin D, the results showed that no patients with normal preoperative vitamin D had a postoperative hypocalcaemia 12, 24, 48 or 72 hours after the operation. After one month, however, 2 patients with normal preoperative vitamin D level, had hypocalcaemia. It worth mention that these two patients had border line normal preoperative vitamin D level. The percentage of patients with low preoperative vitamin D level who had postoperative hypocalcaemia was 5%, 5%, 25% and 15% after the operation by 12, 24, 48 and 72 hours respectively while after one month, the percentage was 10%. The differences between hypocalcaemia incidence between patients with normal and below normal vitamin D levels was statistically significant although it was a borderline significance. The sensitivity and specificity of preoperative vitamin D level in prediction of postoperative hypocalcaemia was 87.50% and 40.91% respectively. Conclusion After investigating the postoperative calcium level in patients with and without preoperative vitamin D deficiency, the study had the following conclusions: Vitamin D deficiency is significantly common among Egyptian population, postoperative hypocalcaemia is closely related to the preoperative vitamin D level and patients with hypovitaminosis D are more labile to hypocalcaemia and females are more likely to have postoperative hypocalcemia.