Post-Operative Hypocalcemia after given Supplementation pre Operatively in Patients Underwent for Total Thyroidectomy

Abstract

Objective: To determine the effect of preoperative   calcium supplementation on postoperative hypocalcemia among patients having total thyroidectomy.  Study Design: Quasi-experimental study.  Place and Duration of Study:   Combined Military Hospital Malir, Pakistan from Oct 2022 to Mar 2023.  Methodology: Patients aged 18 years and above of either gender undergo total thyroidectomy and completion thyroidectomy following hemithyroidectomy were enrolled. Half of the patients received oral calcium supplementation of 500 mg, once a day one week prior to surgery and while the remaining did not receive pre-supplementation. Postoperative hypocalcemia was defined as serum calcium levels lower than 2.2 mmol/L measured 24 hours after surgery.  Results: A significant association of postoperative hypocalcemia was observed in patients with and without preoperative calcium supplementation, i.e., 5(22.7%) and 17(77.3%) respectively (p-value 0.003). Regression analysis showed that after controlling for other covariates, postoperative hypocalcemia was 7.25 times higher among patients without preoperative calcium supplementation (aOR 7.25, 95% CI 2.06 to 25.55), age (aOR 4.27, 95% CI 1.08 to 16.83), and hypertension (aOR 3.75, 95% CI 1.15 to 12.26). A significant difference was observed in the pre-and post-calcium level, i.e., 2.11 ±0.25 mmol/L vs. 2.32 ±0.29 mmol/L respectively (p-value <0.001, 95% CI -0.22 to -0.17).   Conclusion: Preoperative calcium supplementation reduces postoperative hypocalcemia in patients having total thyroidectomy.