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Incidence and risk factors for post-thyroidectomy hypocalcemia.


Related Institution

Section of Endocrinology, Diabetes and Metabolism - St. Luke's Medical Center

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Journal of the ASEAN Federation of Endocrine Societies
Publication Date
May 2016


Objective. This study aimed to determine the incidence and risk factors for post-thyroidectomy hypocalcemia.

Methodology. This was a retrospective study of 242 patients who underwent total or completion thyroidectomy from 2011-2014 at the St. Luke's Medical Center, Quezon City, Philippines. The overall and type-specific incidences of hypocalcemia were determined. Patient and surgery-related factors were assessed and hypocalcemic events described.

Results. Overall incidence of hypocalcemia is 11.98% distributed into symptomatic (10.74%) and asymptomatic (1.24%). The following patient-related factors were not found to be significantly associated with hypocalcemia: age, gender, thyroid disease and thyroid gland weight. Among surgery-related factors, the presence of concomitant complications of thyroidectomy (hoarseness and/or hematoma) and inadvertent parathyroidectomy were significantly associated with hypocalcemia both in the univariate [p=0.046; OR 2.369 (95%CI: 0.995-5.643) and p=0.027; OR 2.426 (95%CI: 1.084-5.432), respectively] and multivariate analyses [p=0.025; OR 2.842 (95%CI: 1.142-7.069) and p=0.013; OR 2.941 (95%CI: 1.252-6.907), respectively]. Other surgery-related factors were not found to be significantly associated with hypocalcemia: extent of thyroidectomy [total vs completion]; neck dissection; surgery duration (hours); and surgeon [consultant vs. trainee].

Among those with symptomatic hypocalcemia, manifestations occurred 29.85±23.07 hours post-operatively and these were: Chvostek's (80.8%), acral paresthesia (76.9%), perioral numbness (46.1%), carpopedal spasm (15.3%), Trousseau's (7.7%) and cramps (3.8%). Those who presented with manifestations of hypocalcemia but with normal serum iCa post-operatively comprised 33.9% of the study population and the majority presented with Chvostek's sign (52%) and acral paresthesia (50%).

Conclusion. In this study, hoarseness and/or hematoma and inadvertent parathyroidectomy are risk factors for post-thyroidectomy hypocalcemia. Closer monitoring of these patients for hypocalcemia may be necessary.

This study aimed to determine the incidence and risk factors for post-thyroidectomy hypocalcemia.


This study aimed to determine the incidence and risk factors for post-thyroidectomy hypocalcemia.


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