(0407) Hispanic Ethnicity: An Independent Risk Factor for Post-Thyroidectomy Hypocalcemia With Associated Increased Length of Stay

Introduction: Post-thyroidectomy hypocalcemia is observed in 24% of patients, particularly those with pre-existing hypovitaminosis D. The Hispanic population, experiencing rates of hypovitaminosis D up to 3 times greater than non-Hispanic patients, may face an elevated risk of postoperative hypocalcemia after central compartment surgery.

Methods: This study assessed patients undergoing total thyroidectomy (TT) or completion thyroidectomy (CT) at our county hospital between April 2001 and August 2023 (n = 151). Outcomes evaluated include transient hypocalcemia, defined by a single reading of low calcium postoperatively, and postoperative hypocalcemia with greater than 24 hours of hospitalization. Univariate and multivariate analyses were used to compare ethnic groups. Results were stratified by surgery type.

Results: We studied 90 Hispanic and 61 non-Hispanic patients. Of them, 119 patients had a TT, while 32 had a CT. When evaluating both TT and CT, Hispanic ethnicity was the only significant predictor of postoperative hypocalcemia with greater than 24 hours of hospitalization (p = 0.045, OR = 2.1 [95% CI: 1.02 to 4.51]). For TTs, Hispanic patients had a 20.6% greater rate of this complication (p = 0.024). When controlling for age, gender, preoperative vitamin D levels, and vitamin D supplementation, Hispanic ethnicity was the only significant predictor of this complication (p = 0.034, OR = 2.6 [95% CI: 1.08 to 6.46]).

Conclusions: At our institution, Hispanic ethnicity was the only significant predictor of post-thyroidectomy hypocalcemia with more than 24 hours of hospitalization when controlling for confounders. The odds of developing this complication were over 2 times greater in Hispanic patients than in non-Hispanic patients. Rates and odds of this complication were even greater among the TT cohort. No significant differences were found in rates of transient hypocalcemia, preoperative hypovitaminosis D, and vitamin D supplementation between ethnic groups. Our study highlights the need for intentional vigilance and aggressive preventative action to mitigate hypocalcemia in this high-risk patient population.