EP70 – Post-total thyroidectomy hypocalcaemia- Treatment factors predicting outcomes

     

    Murthy, Samskruthi P.1, A., Pradeep R. K.4; Balasubramanian, Deepak1; Nair, Vasantha2; Nair, Gopalakrishnan3; Thankappan, Krishnakumar1; Iyer, Subramania1
    1 Department of Head and Neck Oncology, Amrita Institute of Medical Science, Kochi, India
    2 Department of Endocrinology, Amrita Institute of Medical Science, Kochi, India
    3 Department of Endocrine Surgery, Amrita Institute of Medical Science, Kochi, India
    4 Department of Otorhinolaryngology, Amrita Institute of Medical Science, Kochi, India

     

    Aim: To study postoperative calcium supplementation and outcomes in the management of hypocalcaemia (< 8.6) following total thyroidectomy with preserved parathyroid glands

    Materials and methods: Retrospective review between 2013-2015. Details regarding corrected calcium and treatment initiated were recorded. The drugs administered were divided into group 1 – calcium + vit d3, group 2- calcium vitamin d 3 + rocalcitriol, group 3 I- v calcium + drugs. Corrected calcium values at 0, 3 ,6 months and supplementation status were recorded. Discontinuation of drugs and corrected calcium level >8.6 at 6 months were considered as normocalcemia.

    Results: A total of 38 patients were included. 8 (21.1%) patients were in group 1, 11(28.9%) in group 2 and 19(50%) in group 3.  At 3 months most patients in group 2 (n=9, 81.8%) returned to normocalceamia followed by group 1 (N=5,62.5%) and group 3 (N=9,47.4%). At 6 months all patients in group 1 returned to normocalcaemia followed by group 2  (N=10, 90.9%) and group 3 (N=11,57.9%). 21.1% (group 3 N=7, group 2 N=1) of patients had persistent hypocalcaemia at 6 months, out of which 2 returned to normocalcaemia at 14 months. Need for IV calcium correction during immediate posterative period was significantly associated with persistent hypocalcaemia (p=0.01)

    Conclusion: IV Calcium correction after maximum oral calcium correction predicts persistent hypocalcaemia. Persistent hypocalcaemia at 6 months is unlikely to recover in majority of patients.

 

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