title: Correlating pre-operative vitamin D status with post-thyroidectomy hypocalcemia.
abstract: OBJECTIVE
  To examine the relationship between pre-operative vitamin D status and post-thyroidectomy hypocalcemia.
  
  
  METHODS
  Retrospective study examining 264 total and completion thyroidectomies conducted between 2007 and 2011. Subjects included had a recorded 25-hydroxyvitamin D (25[OH]D) level within 21 days prior to or 1 day following surgery, did not have a primary parathyroid gland disorder, and were not taking 1,25-dihydroxyvitamin D3 (calcitriol) prior to surgery. Some subjects were repleted with vitamin D pre-operatively if a low 25(OH)D level (typically below 20 ng/mL) was identified. Pre-operative 25(OH)D, concurrent neck dissection, integrity of parathyroid glands, final pathology, postoperative parathyroid hormone (PTH), calcium nadir and repletion, and length of stay were examined.
  
  
  RESULTS
  The mean pre-operative 25(OH)D for all subjects was 25 ng/mL, and the overall rate of post-operative hypocalcemia was 37.5%. Lower pre-operative 25(OH)D did not predict postoperative hypocalcemia (P = .96); however, it did predict the need for postoperative 1,25-dihydroxyvitamin D3 administration (P = .01). Lower postoperative PTH levels (P = .001) were associated with postoperative hypocalcemia.
  
  
  CONCLUSIONS
  Pre-operative 25(OH)D did not predict a postoperative decrease in serum calcium, although it did predict the need for 1,25-dihydroxyvitamin D3 therapy in hypocalcemic subjects. We recommend that 25(OH)D be assessed and, if indicated, repleted pre-operatively in patients undergoing total thyroidectomy.
authors.forename: Todd E
authors.initials: TE
authors.lastname: Falcone
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Jumaily
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Pearce
authors.forename: Michael F
authors.initials: MF
authors.lastname: Holick
authors.forename: David B
authors.initials: DB
authors.lastname: McAneny
authors.forename: Scharukh
authors.initials: S
authors.lastname: Jalisi
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Grillone
authors.forename: Michael D
authors.initials: MD
authors.lastname: Stone
authors.forename: Anand K
authors.initials: AK
authors.lastname: Devaiah
authors.forename: J Pieter
authors.initials: JP
authors.lastname: Noordzij
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D