The Effect of H2 Antagonists on Hypocalcemia Rate After Thyroidectomy

Tuesday, October 1, 2024

8:30 AM – 8:36 AM EDT

Location: MBCC, 208

Disclosure(s):

Maxwell G. Rossip, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Bao Y. Sciscent, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Nguyen Minh Truong, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Neerav Goyal, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Hypocalcemia is the most common operative risk of thyroidectomy. The long-term use of histamine type 2 (H2) receptor antagonists is also associated with metabolic imbalances including hypocalcemia. The purpose of this study is to examine the risk of hypocalcemia after thyroidectomy in patients taking H2 antagonists.

Methods: The TriNetX Research Network was queried to identify patients who underwent total thyroidectomy between 2011 and 2022. The incidence of transient (0-6 months following thyroidectomy) and permanent (6-12 months following thyroidectomy) postoperative hypocalcemia was compared between patients taking H2 receptor antagonists and controls who were not. Additional analyses were conducted after propensity score matching for demographics and known risk factors for hypocalcemia after thyroidectomy.

Results: There were 38,714 patients who underwent thyroidectomy, of which 14.7% (n = 5,694) were taking H2 antagonists before surgery. Patients taking H2 antagonists had a significantly increased risk of experiencing hypocalcemia at 0-1 month (52.9% vs 47.7%, p < 0.0001), 1-6 months (18.0% vs 14.5%, p < 0.0001), and 6-12 months (13.3% vs 10%, p < 0.0001) compared to controls who were not. Patients taking H2 antagonists were also at increased risk of visiting the emergency department at 1 (7.6% vs 5.9%, p < 0.0001) and 6 months (11% vs 6.7%, p < 0.0001) following surgery compared to controls. The results persisted as significant at all time points after matching.

Conclusions: Patients taking H2 receptor antagonists may be at increased risk of transient and permanent hypocalcemia after thyroid surgery. To this author’s knowledge, this is the first such study indicating an increased risk of hypocalcemia after thyroidectomy in patients taking H2 receptor antagonists.

Presenting Author(s)

Maxwell G. Rossip, BS

Medical Student
Penn State College of Medicine
Hershey, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

F. Jeffrey Lorenz, MD

Resident
Penn State Health Department of Otolaryngology - Head and Neck Surgery
Hummelstown, Pennsylvania, United States

Disclosure information not submitted.
Bao Y. Sciscent, BS

Medical Student
Department of Otolaryngology- Head and Neck Surgery, Penn State Milton S. Hershey Medical Center
Hershey, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Nguyen Minh Truong, BS

Medical Student
Penn State College of Medicine
Hershey, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Chaitanya V. Nimmagadda, BS

Medical Student
Penn State College of Medicine
Hershey, PA, United States

Disclosure information not submitted.
Neerav Goyal, MD, MPH

Associate Professor; Division Chief Head and Neck Surgery; Vice Chair Patient Safety and Quality
Penn State Milton S. Hershey Medical Center
Hershey, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

David Goldenberg, MD

Professor and Chair
Hershey Med Center & Penn State Univ
Hershey, Pennsylvania, United States

Disclosure information not submitted.