KUMJ | VOL. 24 | NO. 3 | ISSUE 96 | JULY-SEPTEMBER, 2026

Retrospective Analysis of Postoperative Hypocalcemia in Total Thyroidectomy Patients and the Role of 24 Hour Intact Parathyroid Hormone as a Predictor
Dangol B, Nepal A, Yadav D, Shrestha N, Maharjan L, Paneru M, Maharjan R

Abstract:
Background Postoperative hypocalcemia, a common complication after total thyroidectomy is multifactorial. The management of early hypocalcemia lack uniformity. Universal or selective supplementation of calcium with or without vitamin D is carried out. The predictors for postoperative hypocalcemia is widely studied in literature with some factors described as independent predictors. Objective To explore occurrence of post-thyroidectomy hypocalcemia along with analysis of factors for predicting early and late hypocalcemia. The efficacy of selective supplementation of calcium with or without vitamin D was studied. Method The retrospective analysis of charts of total thyroidectomy patients above 18 years within a period of four years in a tertiary institute was carried out. The occurrence of early and late hypocalcemia and their relation with several preoperative and intraoperative factors were studied. The rates of readmissions for hypocalcemia symptoms were evaluated. Detailed analysis for relation of 24 hour serum parathyroid hormone with early and late hypocalcemia was done. Result Among 51 patients, 68.62% had early hypocalcemia and 11.76% had late hypocalcemia. Among other factors, 24 hour intact parathormone level showed significant relationship with early hypocalcemia with level less than 15 pg/ml associated with symptomatic status. Out of total patients, 58.8% of patients were treated for early hypocalcemia. None of the patients not supplemented with calcium required readmission for early hypocalcemia symptoms. Conclusion The symptom based treatment of post thyroidectomy hypocalcemia is shown to be effective with intact parathyroid hormone at 24 hours having significant role of predicting symptomatic early hypocalcemia requiring supplementation.
Keyword : Hypocalcemia, Parathormone, Thyroidectomy