Abstract
Objective
1) To evaluate the role of patient gender as a potential risk factor for post-thyroidectomy hypocalcemia. 2)To elucidate, from previous studies, potential physiologic mechanisms underlying any identified gender disparity. 3)To help better predict post-thyroidectomy hypocalcemia and ultimately limit its incidence with prophylactic/early calcium supplementation.
Methods
A retrospective review of 270 consecutive total thyroidectomy patients (October 2004-December 2006) was conducted, consisting of 219 females and 51 males. Postoperative hypocalcemia was defined as any one of the following: total serum calcium of less than or equal to 1.90 mmol/L up to 1 month following surgery or symptoms of hypocalcemia. The following were evaluated as potential confounding factors in the study: age, menopause, pre-operative calcium and parathyroid hormone levels, magnesium and phosphate levels, pathology and number of parathyroid glands preserved in situ. Chisquared testing was used to evaluate for statistical significance.
Results
Female patients experienced transient postoperative hypocalcemia in 24.7% (54/219) of cases, which was significantly greater than the 11.8% (6/51) incidence detected in males (p less than 0.05). This represents a female:male relative risk ratio of 2.1 (C.I. 1.0–4.6). There was no significant difference in rates of hypocalcemia between pre-menopausal (age less than 50) and post-menopausal women (22.7% vs. 26.6%).
Conclusions
These findings suggest that being female is a significant risk factor for transient post-thyroidectomy hypocalcemia. Furthermore, females appear to experience this postoperative complication more than twice as frequently as males. Additional research is needed in order to ascertain the physiologic mechanisms underlying this identified gender difference.
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