Background: Post-operative hypocalcaemia is the most common metabolic complication following thyroid surgery, leading to increased morbidity and prolonged hospital stay. Despite advances in surgical techniques, the risk of hypocalcaemic tetany remains significant. Objectives: The primary objective was to determine the incidence and clinical presentation of temporary hypocalcaemia following thyroid surgery. The secondary objective was to correlate temporary hypocalcaemia with clinical features, type of surgery, age, sex and histopathology, and to determine the timing of its presentation. Materials and Methods: A prospective observational study was conducted at a tertiary care centre, including 151 patients undergoing thyroid surgery. Data were collected on patient demographics, surgical details, biochemical parameters and post-operative clinical findings, with serum calcium monitored post-operatively. Results: The incidence of post-operative hypocalcaemia was 22% (33/151). Most patients were female (82.78%) and in the 41–50 years age group. Total thyroidectomy was performed in 76.2% of patients, and the most common indication was multinodular goitre (75.5%). Hypocalcaemia incidence was highest in patients over 60 years (43.3%, P = 0.0149) and in females (25.6%, P = 0.0146). It was significantly associated with total thyroidectomy (26.1%, P = 0.024) and malignant pathology (35.6%, P = 0.001). The majority (63.6%) developed hypocalcemia on post-operative day 2. Conclusion: Post-thyroidectomy hypocalcaemia is a frequent complication, particularly in elderly patients, females, those undergoing total thyroidectomy and in malignancies. Meticulous surgical technique, preservation of parathyroid glands and early post-operative monitoring can reduce hypocalcaemia-related morbidity.
Ebenezer et al. (Thu,) studied this question.