Endocrine Abstracts

Background: Post-thyroidectomy hypocalcemia is a common complication that results in adverse neurological and cardiac symptoms. The use of calcium and vitamin D has been proposed as a preoperative preventative strategy for this condition. This systematic review and meta-analysis aimed to assess whether preoperative administration of calcium and vitamin D prevents postoperative hypocalcemia.

Methods: Computerized search in Medline, Embase, and CENTRAL databases was performed. Randomized controlled trials (RCTs) comparing preoperative calcium and Vitamin D administration with either placebo or standard therapy were eligible for inclusion. The primary outcomes were the occurrence of hypocalcemia, mean postoperative calcium level, and symptomatic hypocalcemia. The secondary outcomes were the development of permanent hypoparathyroidism and length of hospital stay. Continuous outcomes were represented as mean difference (MD), and dichotomous outcomes were represented as risk ratio (RR).

Results: Total of 9 RCTs that enrolled 1079 patients were found eligible. Postoperative hypocalcemia occurred significantly less in patients who received preoperative calcium and vitamin D (RR = 0.77, 95% CI: 0.60 to 1.00; P = 0.05). Mean postoperative calcium level was significantly higher in the intervention group (MD = 0.10, 95% CI: 0.07 to 0.12; P < 0.00001). The number of patients with symptomatic hypocalcemia was significantly lower in the intervention group (RR = 0.54, 95% CI: 0.38 to 0.76). There was no significant difference between the two groups in cases of permanent hypoparathyroidism and length of hospital stay.

Conclusion: Administration of calcium and vitamin D preoperatively achieves lower rates of post-thyroidectomy hypocalcemia in comparison with placebo and standard therapy.