Preoperative Calcium or Vitamin D Supplement in Thyroidectomy: A Systematic Review and Meta-Analysis

Abstract

Objectives: The objective of this systematic review and meta-analysis was to assess the role of preoperative calcium and vitamin D supplementation in patients who underwent total thyroidectomy. Data Sources: The search for randomized controlled trials was performed in the OVID Medline and Embase databases. Review Methods: The last search was made on September 16, 2024. Three independent reviewers evaluated full-text articles from relevant reports based on eligibility criteria. The quality of the included studies was assessed by two reviewers according to the ROB 2 tool. Results: This systematic review and meta-analysis considered 13 studies with 1504 participants. There were positive results in treatment outcomes including the mean postoperative calcium level (MD, 0.30 mg/dL: 95% CI, 0.15 to 0.44); the 48 h of postoperative hypocalcemia (OR, 0.41; 95% CI, 0.27 to 0.62); the postoperative symptomatic hypocalcemia (OR, 0.38; 95% CI, 0.24 to 0.62); the IV calcium supplementation (OR, 0.32; 95% CI, 0.18 to 0.58); and length of hospital stays (MD, −0.29; 95% CI, −0.51 to −0.07) as compared to the control group. Readmission rates showed no significant differences between the groups (OR, 0.15; 95% CI, 0.01 to 3.08). Conclusions: Preoperative calcium and vitamin D supplementation in patients who underwent total thyroidectomy results in reduction of postoperative symptomatic hypocalcemia. The finding is critical because it offers a feasible and effective solution that could improve patient care while potentially reducing the burden of numerous blood tests during the postoperative period. Registration: This systematic review protocol was registered with PROSPERO (registration number CRD42021278859). Level of Evidence: Level 1 Laryngoscope, 2024.