Evaluation of risk factors of postoperative Hypocalcemia following total Thyroidectomy: A study from tertiary care hospital.

Objective: To evaluate the risk factors and assess the prevalence of postoperative hypocalcemia in patients having acomplete thyroidectomy at a Karachi tertiary care hospital.Methodology: The ENT Department at Sir Syed Hospital in Karachi conducted this retrospective study from March 2022to February 2025, over a span of three years. A total of 108 patients who underwent complete thyroidectomies had theirmedical records reviewed. The collected data included postoperative biochemical outcomes, details of the surgery, diagnoses,and demographic characteristics. Hypocalcemia was defined as total serum calcium levels below 8.0 mg/dlwithin 48 hours post-surgery. The statistical analysis employed multivariate logistic regression and chi-square tests todetermine independent variables.Results: The incidence of postoperative hypocalcemia was noted in 37 patients, representing 34.3% of the total 108 patients.Factors significantly linked to hypocalcemia included female gender (p=0.032), central neck dissection (p=0.01),Hashimoto's thyroiditis (p=0.004), and unintentional parathyroidectomy (p<0.001). The multivariate analysis identifiedthe following independent predictors: Hashimoto's thyroiditis (OR: 3.1, 95% CI: 1.3–7.5), central neck dissection (OR:2.8, 95% CI: 1.2–6.7), and excision of the parathyroid gland (OR: 5.2, 95% CI: 2.1–12.9)Conclusion: Following a total thyroidectomy, postoperative hypocalcemia is a common consequence. The risk can bedecreased by preserving the parathyroid glands, minimizing central dissection, and meticulously identifying thyroiditis. Keywords: Hypocalcemia, total thyroidectomy, parathyroidectomy, central neck dissection, thyroiditis.