Pilot of a randomized prospective observational study of vitamin D deficiency as a predictor of postoperative hypocalcemia in a cohort of patients undergoing total thyroidectomy

Abstract Background Temporary hypocalcemia is common following total thyroidectomy hypocalcemia and is attributed to inadvertent parathyroid gland injury or ischemia. This postoperative hypocalcemia may be made worse by the disturbance of calcium metabolism brought on by vitamin D insufficiency (VDD). Materials and Methods A prospective randomized observational pilot study was conducted at a tertiary care hospital in South India. In this study, 29 patients were categorized by preoperative vitamin D levels into 3 groups: group A (normal vitamin D), group B (deficient but supplemented), and group C (deficient without supplementation). Corrected calcium was evaluated daily for postoperative biochemical hypocalcemia along with clinical features of hypocalcemia. Data were recorded and statistically analyzed. Chi-square tests were used to evaluate associations. Results Postoperative hypocalcemia was significantly higher in patients with preoperative vitamin D deficiency, group C ( p < 0.003), compared to groups A and B. Preoperative supplementation significantly reduced hypocalcemia rates in group B. Conclusions The pilot study shows a significant association between vitamin D deficiency and postoperative hypocalcemia following total thyroidectomy. Patients with preoperative vitamin D deficiency, especially without supplementation, are at higher risk. Early identification and correction of vitamin D deficiency may mitigate the incidence of postoperative hypocalcemia, thereby potentially improving patient outcomes and reducing healthcare costs.