One of the commonest complications of total thyroidectomy (TT) is hypoparathyroidism due to unintentional removal or damage to the parathyroid glands and/or their vascularisation. While transient hypoparathyroidism is common, the condition is only chronic (present for more than 12 months postoperatively) in a minority of patients. Importantly, previous studies suggest that chronic hypoparathyroidism might affect mortality.

This study by Reinke et al. used population-based registries to evaluate the frequency of hypoparathyroidism and mortality in patients undergoing TT in Denmark between 1998 and 2017. Based on 7,912 patients who underwent TT within the study period, the prevalence of hypoparathyroidism was 16.6% at 12 months postoperatively. After adjusting for confounders, they showed the risk of death due to any cause following TT was significantly higher in those who developed hypoparathyroidism (hazard ratio (HR) 1.34). However, subgroup analysis revealed that mortality was only higher in cases with malignancy (HR 2.48), and not when surgery was performed for benign indications, such as goitre (HR 0.88) or thyrotoxicosis (HR 0.86).

Therefore, they conclude that patients with hypoparathyroidism do not have an increased risk of mortality following TT, unless the surgery was for malignancy.

Read the full article in Clinical Endocrinology 100 408–415 https://doi.org/10.1111/cen.15037