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Incidence and predictive factors of postoperative hypocalcaemia according to type of thyroid surgery in older adults

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A Correction to this article was published on 26 November 2021

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Abstract

Purpose

Transient hypocalcaemia after thyroid surgery and its possible predictors have not been extensively described in the elderly. This study aimed to establish the frequency of postsurgical transient hypocalcaemia according to the extent of thyroid surgery in older adults and to assess mineral metabolism biochemical parameters as its predictors.

Methods

All patients ≥60 years undergoing thyroid surgery were prospectively included. Type of surgery (hemithyroidectomy(HT) or total thyroidectomy(TT)); and preoperative 25OH Vitamin D (25OHD) and pre and 6 (only TT), 24 h and 6 months postsurgical serum levels of calcium, magnesium, phosphate and parathormone (PTH) were considered. Postsurgical hypoparathyroidism (hPTpost) was defined at PTH levels ≤11 pg/mL.

Results

Out of 46 patients (87% female), age (mean ± SD) 70.1 ± 6.2 years, 24 h postsurgical hypocalcaemia was found in ten patients (22%). In 25 (54%) TT patients, 36% and 16% had postsurgical hypocalcaemia at 6 and 24 h respectively; 28% hPTpost but no definitive hPT was recorded and 44% had 25OHD deficiency. Lower 24 h magnesium levels were found in those TT patients with 24 h hypocalcaemia (1.6 ± 0.1 vs 1.9 ± 0.1 mg/dL (p = 0.005)). Among 21 (46%) HT patients, 28.6% had 24 h postsurgical hypocalcaemia; 9.5% had hPTpost. A positive correlation was observed between preoperative 25OHD and 24 h calcaemia (r:0.51,p = 0.02). 43% of the patients were 25OHD deficient, in whom 55% had 24 h hypocalcaemia vs only 9% in the 25OHD sufficient group (p = 0.049).

Conclusion

Postsurgical hypocalcaemia was common in elderly thyroidectomized patients. After TT, lower magnesium levels were found in those patients with 24 h hypocalcaemia. In the HT group, preoperative 25OHD deficiency predicted lower postsurgical calcium levels.

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Data availability

All data and material was collected at Dr. Cesar Milstein Care Unit, Buenos Aires.

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Acknowledgements

We would like to thank the Endocrine and Surgery residents of Dr. Cesar Milstein Unit Care for their support in the follow-up of patients and collection of data.

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Authors and Affiliations

  1. Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina

    María Paz Barbier, Evelin Mingote, Noelia Sforza, Yanina Morosán Allo, Cristina Faingold, Claudia Sedlinsky & Gabriela Brenta

  2. Servicio de Cirugía General, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina

    Maximiliano Lotartaro & Leonardo Serrano

  3. Laboratorio Central, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina

    María Pía Fossati

  4. Laboratorio de Biomarcadores y Nutrimetabolómica, Departamento de Nutrición, Ciencias de la Alimentación y Gastronomía, Red de Referencia en Tecnología de Alimentos (XaRTA), Instituto de Nutrición y Seguridad Alimentaria (INSA), Facultad de Farmacia y Ciencias de la Alimentación, Universidad de Barcelona, Barcelona, Spain

    Tomas Meroño

  5. CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain

    Tomas Meroño

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  1. María Paz Barbier
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [B.M.P., S.N., M.A.Y., L.M., S.L., S.C., M.T., F.C., F.M.P. and B.G.]. The first draft of the paper was written by [B.M.P., M.E., S.C. and B.G.] and all authors commented on previous versions of the paper. All authors read and approved the final paper.

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Correspondence to Gabriela Brenta.

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All participants gave a written voluntary consent to participate.

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The protocol was approved by the Ethics Committee for human studies of Dr. Cesar Milstein Care Unit, Buenos Aires.

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Barbier, M.P., Mingote, E., Sforza, N. et al. Incidence and predictive factors of postoperative hypocalcaemia according to type of thyroid surgery in older adults. Endocrine 75, 276–283 (2022). https://doi.org/10.1007/s12020-021-02840-9

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