Hypocalcemia Post Total Thyroidectomy: A Ten-Year, Single Institution Experience With a Parathyroid Hormone-Guided Calcium and Calcitriol Supplementation Protocol
Authors' conclusion
A PTH-guided Ca and calcitriol supplementation protocol significantly reduces post-TT hypocalcemia and related readmissions and may represent a useful approach in managing suitable candidates for outpatient TT.
Study context
- Population
- Patients who underwent total thyroidectomy (TT), single institution, 10-year experience
- Participants
- 735 vs 148
- Exposure
- Parathyroid hormone (PTH)-guided calcium (Ca) and calcitriol supplementation protocol vs preprotocol
- Postprotocoln = 735
- Preprotocoln = 148reference
- Outcome
- Incidence of hypocalcemia (total serum Ca < 8 mg/dL) after TT
Methodological detailssingle-institution, retrospective chart review, pre-post protocol comparison, multivariable logistic regression
- Single-institution
- Retrospective chart review
- Pre-post protocol comparison
- Multivariable logistic regression
Main finding
As reported in the abstract
Hypocalcemia incidence
P < 0.001
Observational data: associations, not effects.
Further findings
Hypocalcemia-related readmissions · significantly lower with Postprotocol
P = 0.004
Hypocalcemia by 4-hour PTH
- Hypocalcemia with PTH <15 pg/mL
- 24.3%
- Hypocalcemia with PTH >30 pg/mL
- 2.3%
Risk factors for hypocalcemia
- Lymph node dissection and parathyroids embedded in thyroid tissue were significant risk factors for hypocalcemia
Original publication
Hypocalcemia Post Total Thyroidectomy: A Ten-Year, Single Institution Experience With a Parathyroid Hormone-Guided Calcium and Calcitriol Supplementation Protocol. Endocr Pract. Published 7 July 2025. doi:10.
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