What are the real rates of temporary hypoparathyroidism following thyroidectomy? It is a matter of definition: a systematic review

Endocrine. 2021 Jul;73(1):1-7. doi: 10.1007/s12020-021-02663-8. Epub 2021 Mar 2.

Abstract

Introduction: Post-operative hypoparathyroidism is the most encountered complication of thyroid surgery and is classified as temporary or permanent. However, its incidence varies greatly in the literature ranging from 0.5% to 65%. This can be mainly attributed to the different definition of hypoparathyroidism used in each study and especially to the different time cutoff applied to distinguish temporary from permanent hypoparathyroidism.

Methods: We conducted a systematic literature search in PubMed, Scopus, Cochrane and GoogleScholar databases, as well as grey literature. Ultimately, 45 articles with 23,164 patients in total were included in this review. These articles used either the cutoff of six or twelve post-operative months to distinguish temporary from permanent hypoparathyroidism.

Results: The overall incidence of permanent hypoparathyroidism diagnosed at 6 months post-operatively was 4.11% and 4.08% at 12 months post-operatively. There was no statistically significant difference between the two groups (p = 0.92).

Conclusions: We suggest that adhering to the current guidelines that recommend diagnosing temporary hypoparathyroidism when recovery is made within 6 months after surgery is important when conducting future research in order to narrow the gap that exists currently in the literature, as well as when deciding to put patients on long-term calcium supplements.

Keywords: Hypocalcaemia; Hypocalcemia; Hypoparathyroidism; Post-operative; Thyroidectomy.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Hypocalcemia*
  • Hypoparathyroidism* / diagnosis
  • Hypoparathyroidism* / epidemiology
  • Hypoparathyroidism* / etiology
  • Parathyroid Glands
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Thyroid Gland
  • Thyroidectomy / adverse effects