World Journal of Surgery

, Volume 35, Issue 2, pp 324–330 | Cite as

Preoperative Vitamin D Deficiency Predicts Postoperative Hypocalcemia After Total Thyroidectomy

  • James Kirkby-Bott
  • Haridimos Markogiannakis
  • Anita Skandarajah
  • Matthew Cowan
  • Bill Fleming
  • Fausto PalazzoEmail author



Transient postthyroidectomy hypocalcemia occurs in up to 30% of patients. We evaluated the effect of vitamin D deficiency on postthyroidectomy hypocalcemia.


Data were collected prospectively between January 2006 and March 2009. A total of 166 consecutive total thyroidectomies were analyzed regarding the relation between preoperative vitamin D3 levels and postoperative corrected calcium levels. Patients were divided into three groups dependent upon the preoperative vitamin D3 level: group 1, <25 nmol/l; group 2, 25–50 nmol/l; group 3, >50 nmol/l (conversion factor of 2.5× between nanomoles per liter and nanograms per milliliter). Hypocalcemia was defined as a postoperative calcium level <2.00 mmol/l (8 mg/dl). Hospital length of stay was recorded.


There was a difference in postoperative hypocalcemia between the three vitamin D3 groups (group 1 (32%) vs. group 2 (24%) vs. group 3 (13%). Hypocalcemia in group 1 (vit D <25 nmol/l, <10 ng/ml) was significantly more likely than in group 3 (vit D >50 nmol/l, >20 ng/ml) (P = 0.025, χ2 test. Vitamin D3 deficiency was also associated with a longer hospital stay (median stay 2 days vs. 1 day, P < 0.001, Wilcoxon rank test).


There is a significant difference in postoperative hypocalcemia rates between those with vitamin D levels >50 nmol/l (>20 ng/ml) and those with a level of <25 nmol/l (<10 ng/ml). Vitamin D deficiency leads to a delay in discharge owing to a higher likelihood of hypocalcemia.


Parathyroid Gland Total Thyroidectomy Normal Reference Range Permanent Hypoparathyroidism Corrected Calcium 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflicts of interest

The authors have no conflicts to disclose.


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Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • James Kirkby-Bott
    • 1
  • Haridimos Markogiannakis
    • 1
  • Anita Skandarajah
    • 1
  • Matthew Cowan
    • 2
  • Bill Fleming
    • 1
  • Fausto Palazzo
    • 1
    Email author
  1. 1.Department of Endocrine SurgeryHammersmith Hospital, Imperial College NHS TrustLondonUK
  2. 2.Division of Cellular and Molecular MedicineSt. George’s, University of LondonLondonUK

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