Association Between Vitamin D Levels and Transient Postoperative Hypocalcemia in Thyroidectomy

Abstract

Transient postoperative hypocalcemia (TPH) is the most common complication after thyroidectomy. Several studies have suggested that vitamin D deficiency may play a role in its occurrence, although available evidence remains inconsistent. The objective was to evaluate the association between serum vitamin D levels and the occurrence of TPH in patients undergoing total thyroidectomy for thyroid disease. Materials and methods: An observational, analytical, and retrospective study was conducted in patients over 18 years of age who underwent surgery at Hospital Dr. Arturo Oñativia during 2022 and 2023. Patients with diseases or treatments that could alter calcium-phosphate metabolism were excluded. TPH was defined as serum calcium <8.5 mg/dL during the first two postoperative days. Vitamin D [25(OH)D] levels were classified as sufficient (≥30 ng/mL), insufficient (20–29 ng/mL), deficient (<20 ng/mL), or severely deficient (<10 ng/mL). Results: Ninety-seven patients were analyzed, with a median age of 53 years; 85.6% were women. Pathology was benign in 60.8% and malignant in 39.2%. Total thyroidectomy was performed in 77.3% and thyroidectomy with neck dissection in 22.7%. The overall incidence of TPH was 59.6%. Regarding 25(OH)D, 10.3% had sufficient levels, 34% insufficient, 47.4% deficient, and 8.2% severely deficient. No significant association was found between 25(OH)D levels and the occurrence of TPH. The type of surgery was significantly associated with TPH (OR 5.54; 95% CI 1.52–18.65; p<0.006). Conclusion: In this cohort, vitamin D deficiency was not associated with the occurrence of transient postoperative hypocalcemia.