Post-Thyroidectomy Hypocalcemia: Serum Calcium Levels and Pharmacological Management—A Retrospective Cohort Study

Abstract Context: Post-thyroidectomy hypocalcemia is a common complication of thyroid surgery that requires early recognition and appropriate management. This study evaluated postoperative serum calcium levels and pharmacological management in patients undergoing thyroidectomy at a tertiary care teaching hospital. Materials and Methods: A retrospective hospital-based cohort study was conducted among 91 adult patients who underwent thyroidectomy. Demographic characteristics, type of surgery, postoperative serum calcium levels, and calcium/vitamin D 3 supplementation from hospital records were analyzed. Median postoperative serum calcium levels were compared using the Mann–Whitney U test, and simple binary logistic regression was performed to evaluate the association between thyroidectomy type and postoperative hypocalcemia. Results: Post-thyroidectomy hypocalcemia (serum calcium <8.5 mg/dL) occurred in 54 of 91 patients (59.3%). Postoperative serum calcium levels were lower in patients undergoing total thyroidectomy than in those undergoing partial thyroidectomy [median: 7.60 (interquartile range, IQR: 7.50–8.60) vs. 8.40 (IQR: 8.30–9.15) mg/dL; P = 0.021]. Total thyroidectomy was associated with a higher odds of early postoperative biochemical hypocalcemia than partial thyroidectomy (odds ratio: 7.19, 95% confidence interval: 1.84–28.06; P = 0.001). Among patients with hypocalcemia, 50 (92.6%) were managed with oral calcium-based therapy—calcium carbonate (median elemental calcium dose: 1500 mg/day), supplemented with cholecalciferol (median dose: 4000 IU/day) as clinically indicated—while 4 (7.4%) required intravenous calcium. Conclusions: Hypocalcemia post-thyroidectomy was observed in 59.3% of the patients. Total thyroidectomy was significantly associated with a lower postoperative serum calcium level. Most patients were treated empirically with oral calcium supplementation, with or without vitamin D 3 .