Reducing hypocalcemia in patients undergoing thyroidectomy for Graves’ disease with a parathyroid hormone based protocol - 09/10/25
, Zhixing Song b, d, Ashba Allahwasaya b, Kerrick Akinola b, Sanjana Balachandra b, Raj Roy b, Andrea Gillis b, Jessica Fazendin c, Brenessa Lindeman b, Herbert Chen bAbstract |
Introduction |
Patients with Graves' disease have a high risk of post-thyroidectomy hypocalcemia. Our aim was to evaluate the postoperative outcomes of hypoparathyroidism and hypocalcemia in Graves' disease.
Methods |
A prospectively maintained, single institution database was retrospectively reviewed to identify patients with Graves' Disease who had undergone total or completion thyroidectomy. The primary outcomes of interest were postoperative hypoparathyroidism and hypocalcemia and secondary outcomes included surgical complication rates. Outcomes were further stratified based on post-anesthesia care unit (PACU) measurement of parathyroid hormone (PTH) levels and preoperative thyrotoxic status.
Results |
Of the 245 Graves' thyroidectomy patients identified, nearly a third of patients (32.0 %) were thyrotoxic preoperatively. In the PACU, 26.5 % of patients had a PTH <10 pg/mL, although 62.9 % of these patients had normal PTH levels two-weeks postoperatively. Postoperative hypoparathyroidism was associated with White race and hypocalcemia two-weeks post-operatively. Thyrotoxic patients were more likely to have persistent hypocalcemia.
Conclusion |
In this large series of Graves' patients undergoing thyroidectomy, in which a substantial proportion of patients had uncontrolled disease, a quarter of patients had hypoparathyroidism immediately after surgery, although this self-resolved for more than half of patients.
Le texte complet de cet article est disponible en PDF.Highlights |
• | For Graves' patients, immediate post-thyroidectomy hypoparathyroidism was common. |
• | A majority of immediate post-thyroidectomy hypoparathyroidism resolved spontaneously. |
• | Postoperative hypoparathyroidism was associated with White race. |
• | Thyrotoxic patients were more likely to have persistent hypocalcemia. |
Keywords : Graves' disease, Thyroidectomy, Hypoparathyroidism, Hypocalcemia
Plan
| ☆ | PRESENTATION: Quickshot Presentation at the Academic Surgical Congress Annual Meeting, Washington, D.C., February 6–8th 2024. |
Vol 249
Article 116570- novembre 2025 Retour au numéro
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