SAT-743 - The Effect of Glucocorticoid Treatment on Hypocalcemia Following Thyroid Surgery: An Updated Systematic Review and Meta-Analysis

Background:
Postoperative hypocalcemia is a common complication of thyroid surgery, largely resulting from transient or permanent parathyroid dysfunction, and is associated with increased morbidity and prolonged hospitalization. Glucocorticoids have been proposed as a preventive strategy due to their anti-inflammatory effects and potential to reduce postoperative parathyroid edema, but evidence regarding their effectiveness remains inconsistent. This updated systematic review and meta-analysis aimed to evaluate the impact of perioperative glucocorticoid administration on the incidence of hypocalcemia following thyroid surgery.

Methods:
A comprehensive systematic search of major electronic databases was performed to identify randomized and comparative clinical studies assessing glucocorticoid therapy versus standard care or placebo in patients undergoing thyroid surgery. Primary outcomes included the incidence of postoperative biochemical hypocalcemia and symptomatic hypocalcemia. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models.

Results:
Ten studies encompassing 779 patients were included, with 369 patients receiving glucocorticoids and 410 patients serving as controls. Perioperative glucocorticoid use significantly reduced the incidence of postoperative biochemical hypocalcemia (RR 0.49; 95% CI 0.29–0.84). A significant reduction was also observed in postoperative symptomatic hypocalcemia among patients treated with glucocorticoids (RR 0.40; 95% CI 0.21–0.79). These benefits were consistent across included studies.

Conclusion:
Perioperative glucocorticoid administration significantly lowers the risk of both biochemical and symptomatic hypocalcemia after thyroid surgery. Short-term glucocorticoid therapy may therefore be considered an effective adjunct to reduce postoperative hypocalcemia and improve early postoperative outcomes, although further high-quality trials are needed to establish optimal dosing and long-term safety.

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