Correlating Pre-Operative Vitamin D Status with Post-Thyroidectomy Hypocalcemia |
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| Institution: | 1. From the Division of Otolaryngology-Head & Neck Surgery, University of Connecticut School of Medicine, Farmington, Connecticut;2. Department of Internal Medicine, University of Virginia Health System, Charlottesville, Virginia;3. Department of Otolaryngology-Head & Neck Surgery, Boston University Medical Center, Boston, Massachusetts;4. Section of Endocrinology, Diabetes, and Nutrition, Boston University Medical Center, Boston, Massachusetts;5. Department of General Surgery, Boston University Medical Center, Boston, Massachusetts;6. Department of General Surgery, Stamford Hospital, Stamford, Connecticut.;1. From the Department of Endocrinology and Metabolism, Guangzhou General Hospital of Guangzhou Command of PLA, Guangzhou, China;2. Department of Neurosurgery, Guangzhou General Hospital of Guangzhou Command of PLA, Guangzhou, China;3. South China Medical Center for Pituitary Tumor, Guangzhou General Hospital of Guangzhou Command of PLA, Guangzhou, China;4. Department of Endocrinology, The Second People''s Hospital of Guangdong Province, Guangzhou, China.;1. From the Department of Medicine, Albany Medical College, Albany, New York.;2. Department of Surgery, Albany Medical College, Albany, New York. |
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| Abstract: | Objective: To examine the relationship between pre-operative vitamin D status and post-thyroidectomy hypocalcemia.Methods: Retrospective study examining 264 total and completion thyroidectomies conducted between 2007 and 2011. Subjects included had a recorded 25-hydroxyvitamin D (25OH]D) level within 21 days prior to or 1 day following surgery, did not have a primary parathyroid gland disorder, and were not taking 1,25-dihydroxyvitamin D3 (calcitriol) prior to surgery. Some subjects were repleted with vitamin D pre-operatively if a low 25(OH)D level (typically below 20 ng/mL) was identified. Pre-operative 25(OH)D, concurrent neck dissection, integrity of parathyroid glands, final pathology, postoperative parathyroid hormone (PTH), calcium nadir and repletion, and length of stay were examined.Results: The mean pre-operative 25(OH)D for all subjects was 25 ng/mL, and the overall rate of post-operative hypocalcemia was 37.5%. Lower pre-operative 25(OH)D did not predict postoperative hypocalcemia (P =.96); however, it did predict the need for postoperative 1,25-dihydroxyvitamin D3 administration (P =.01). Lower postoperative PTH levels (P =.001) were associated with postoperative hypocalcemia.Conclusion: Pre-operative 25(OH)D did not predict a postoperative decrease in serum calcium, although it did predict the need for 1,25-dihydroxyvitamin D3 therapy in hypocalcemic subjects. We recommend that 25(OH)D be assessed and, if indicated, repleted pre-operatively in patients undergoing total thyroidectomy.Abbreviations: 25(OH)D = 25-hydroxyvitamin D PTH = parathyroid hormone |
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