Hypocalcemia after Thyroidectomy: The Need for Improved Definitions

ABSTRACT Introduction Hypocalcemia and permanent hypoparathyroidism are important outcome measures after total thyroidectomy. The aim of this article is to identify and highlight the wide variation in the adequacy/definition of these complications as reported in the surgical literature. Methods Nineteen journal articles (2008) on complications of thyroidectomy and 17 journal articles (2002) on ‘prediction’ of postthyroidectomy hypocalcemia derived from a PubMed search were reviewed. Results Only 21% of studies of describing outcome and complications of thyroidectomy defined hypocalcemia, temporary/permanent hypoparathyroidism. 47% of studies on the early prediction of hypocalcemia failed to quote their normal range of serum calcium. When stated, the biochemical definition of hypocalcemia varied from 1.8 to 2.12 mmol/l. There is no consistent definition of post-thyroidectomy hypoparathyroidism. Conclusion There is no consensus apparent on literature review as to what constitutes post-thyroidectomy hypocalcemia and hypoparathyroidism. The need to benchmark and define appropriate outcome measures of thyroid surgery demands that this deficit is addressed.