pp 1–11 | Cite as

Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis

  • Juan J. DíezEmail author
  • Emma Anda
  • Julia Sastre
  • Begoña Pérez Corral
  • Cristina Álvarez-Escolá
  • Laura Manjón
  • Miguel Paja
  • Marcel Sambo
  • Piedad Santiago Fernández
  • Concepción Blanco Carrera
  • Juan C Galofré
  • Elena Navarro
  • Carles Zafón
  • Eva Sanz
  • Amelia Oleaga
  • Orosia Bandrés
  • Sergio Donnay
  • Ana Megía
  • María Picallo
  • Cecilia Sánchez Ragnarsson
  • Gloria Baena-Nieto
  • José Carlos Fernández García
  • Beatriz Lecumberri
  • Manel Sahún de la Vega
  • Ana R. Romero-Lluch
  • Pedro Iglesias
Original Article



The prevalence of postoperative hypoparathyroidism has been studied in registries and in surgical series with highly variable and imprecise results. However, the frequency of this hormonal deficiency in the clinical practice of endocrinologists is not known with accuracy. We aimed to assess the prevalence and risk factors of hypoparathyroidism in patients undergoing total thyroidectomy in Spain.


We designed a retrospective, multicentre and nation-wide protocol including all patients with total thyroidectomy who were seen in the endocrinology clinic of the participant centers from January to March 2018. Prevalence of hypoparathyroidism was evaluated at discharge of surgery, 3–6 months after surgery, 12 months after surgery and at last visit. Twenty hospitals participated in the study.


Of 1792 patients undergoing total thyroidectomy, 866 (48.3%) developed postoperative hypoparathyroidism at discharge of surgery. Most of them recover parathyroid function over time. Prevalence of hypoparathyroidism at 3–6 months, 12 months and at last visit was 22.9%, 16.7% and 14.5%, respectively. The risk of developing definitive hypoparathyroidism was related to the presence of parathyroid tissue at histology, lymph node dissection, and two-stage thyroidectomy. Patients with thyroid cancer, with higher postoperative calcium levels and treated by expert surgical teams exhibited lower risk of developing permanent hypoparathyroidism.


Although most patients with postsurgical hypoparathyroidism recover parathyroid function, the prevalence of permanent disease in clinical practice is non negligible (14.5%). Postoperative calcium, extent and timing of surgery, the presence of cancer, expert surgical team, and parathyroid tissue at histology are predictors of permanent hypoparathyroidism.


Thyroidectomy Hypoparathyroidism Hypocalcemia Thyroid surgery Prevalence Risk factors 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019
corrected publication 2019

Authors and Affiliations

  • Juan J. Díez
    • 1
    • 20
    Email author
  • Emma Anda
    • 2
  • Julia Sastre
    • 3
  • Begoña Pérez Corral
    • 4
  • Cristina Álvarez-Escolá
    • 5
  • Laura Manjón
    • 6
  • Miguel Paja
    • 7
  • Marcel Sambo
    • 8
  • Piedad Santiago Fernández
    • 9
  • Concepción Blanco Carrera
    • 10
  • Juan C Galofré
    • 11
  • Elena Navarro
    • 12
  • Carles Zafón
    • 13
  • Eva Sanz
    • 13
  • Amelia Oleaga
    • 7
  • Orosia Bandrés
    • 14
  • Sergio Donnay
    • 15
  • Ana Megía
    • 16
  • María Picallo
    • 8
  • Cecilia Sánchez Ragnarsson
    • 6
  • Gloria Baena-Nieto
    • 17
  • José Carlos Fernández García
    • 18
  • Beatriz Lecumberri
    • 5
  • Manel Sahún de la Vega
    • 19
  • Ana R. Romero-Lluch
    • 12
  • Pedro Iglesias
    • 1
    • 20
  1. 1.Department of EndocrinologyHospital Universitario Ramón y CajalMadridSpain
  2. 2.Department of EndocrinologyComplejo Hospitalario de NavarraPamplonaSpain
  3. 3.Department of EndocrinologyComplejo Hospitalario de ToledoToledoSpain
  4. 4.Department of EndocrinologyComplejo Asistencial Universitario de LeónLeónSpain
  5. 5.Department of EndocrinologyHospital Universitario La PazMadridSpain
  6. 6.Department of EndocrinologyHospital Universitario Central de AsturiasOviedoSpain
  7. 7.Department of EndocrinologyHospital Universitario de BasurtoBilbaoSpain
  8. 8.Department of EndocrinologyHospital Universitario Gregorio MarañónMadridSpain
  9. 9.Department of EndocrinologyComplejo Hospitalario de JaénJaénSpain
  10. 10.Department of EndocrinologyHospital Universitario Príncipe de Asturias, Alcalá de HenaresMadridSpain
  11. 11.Department of EndocrinologyClínica Universidad de NavarraPamplonaSpain
  12. 12.Department of EndocrinologyHospital Universitario Virgen del RocíoSevillaSpain
  13. 13.Department of EndocrinologyHospital Universitari Vall d’HebronBarcelonaSpain
  14. 14.Department of EndocrinologyHospital Royo VillanovaZaragozaSpain
  15. 15.Department of EndocrinologyFundación Hospital de Alcorcón, AlcorcónMadridSpain
  16. 16.Department of Endocrinology, Hospital Universitario de Tarragona Joan XXIII, IISPVUniversitat Rovira i Virgili, CiberdemTarragonaSpain
  17. 17.Department of EndocrinologyHospital de Jerez, Jerez de la FronteraCádizSpain
  18. 18.Department of EndocrinologyHospital Virgen de la VictoriaMálagaSpain
  19. 19.Department of EndocrinologyHospital Moisès Broggi, Sant Joan DespíBarcelonaSpain
  20. 20.Department of EndocrinologyHospital Universitario Puerta de Hierro MajadahondaMadridSpain

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