{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:22:37Z","timestamp":1779916957745,"version":"3.53.1"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T00:00:00Z","timestamp":1544400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Post\u2010thyroidectomy hypocalcaemia is a significant cause of morbidity and prolonged hospitalization, usually due to transient parathyroid gland damage, treated with calcium and vitamin D supplementation. We present a randomized, double\u2010blinded placebo\u2010controlled trial of preoperative loading with high\u2010dose cholecalciferol (300\u00a0000 IU) to reduce post\u2010thyroidectomy hypocalcaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Measurements<\/jats:title><jats:p>Patients (n\u00a0=\u00a0160) presenting for thyroidectomy at tertiary hospitals were randomized 1:1 to cholecalciferol (300\u00a0000\u00a0IU) or placebo 7\u00a0days prior to thyroidectomy. Ten patients withdrew prior to surgery. The primary outcome was post\u2010operative hypocalcaemia (corrected calcium &lt;2.1\u00a0mmol\/L in first 180\u00a0days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 150 patients undergoing thyroidectomy for Graves\u2019 disease (31%), malignancy (20%) and goitre (49%). Mean pre\u2010enrolment vitamin D was 72\u00a0\u00b1\u00a026\u00a0nmol\/L. Postoperative hypocalcaemia occurred in 21\/72 (29%) assigned to cholecalciferol and 30\/78 (38%) participants assigned to placebo (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.23). There were no differences in secondary end\u2010points between groups. In pre\u2010specified stratification, baseline vitamin D status did not predict hypocalcaemia, although most individuals were vitamin D replete at baseline. Post\u2010hoc stratification by day 1 parathyroid hormone (PTH) (&lt;10\u00a0pg\/mL, low vs \u226510\u00a0pg\/mL, normal) was explored due to highly divergent rates of hypocalcaemia in these groups. Using a Cox regression model, the hazard ratio for hypocalcaemia in the cholecalciferol group was 0.56 (95%CI 0.32\u20100.98, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04) after stratification for Day 1 PTH. Further clinical benefits were observed in these subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pre\u2010thyroidectomy treatment with high\u2010dose cholecalciferol did not reduce the overall rate of hypocalcaemia following thyroidectomy. In subgroups stratified by day 1 PTH status, improved clinical outcomes were noted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13897","type":"journal-article","created":{"date-parts":[[2018,11,2]],"date-time":"2018-11-02T01:04:09Z","timestamp":1541120649000},"page":"343-350","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["High\u2010dose preoperative cholecalciferol to prevent post\u2010thyroidectomy hypocalcaemia: A randomized, double\u2010blinded placebo\u2010controlled trial"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9652-6562","authenticated-orcid":false,"given":"Christopher W.","family":"Rowe","sequence":"first","affiliation":[{"name":"Department of Endocrinology John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Arthurs","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine J.","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  New South Wales Australia"},{"name":"Department of Surgery John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Hawthorne","sequence":"additional","affiliation":[{"name":"Department of Surgery John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Surgery John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Wynne","sequence":"additional","affiliation":[{"name":"Department of Endocrinology John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cino","family":"Bendinelli","sequence":"additional","affiliation":[{"name":"Department of Surgery John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.1746"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2017.09.14"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-010-0872-y"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP161411.OR"},{"key":"e_1_2_8_6_1","unstructured":"KhoslaS.(2008)Hypercalaemia and hypocalcaemia. 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