Early Postoperative PTH Levels as a Predictor of Hypocalcaemia and Facilitating Safe Early Discharge After Total Thyroidectomy
Hypocalcaemia after total or completion thyroidectomy has traditionally required 48 hours or longer inpatient monitoring of serum calcium levels. The use of parathyroid hormone (PTH) levels to predict postoperative hypocalcaemia is well established. This study aimed to measure the impact of a manage...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2007-07-01
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| Series: | Asian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958408600196 |
| _version_ | 1818163150031159296 |
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| author | Simon Grodski Stephen Farrell |
| author_facet | Simon Grodski Stephen Farrell |
| author_sort | Simon Grodski |
| collection | DOAJ |
| description | Hypocalcaemia after total or completion thyroidectomy has traditionally required 48 hours or longer inpatient monitoring of serum calcium levels. The use of parathyroid hormone (PTH) levels to predict postoperative hypocalcaemia is well established. This study aimed to measure the impact of a management plan based on postoperative PTH on achieving safe early discharge after thyroidectomy.
Methods: A prospective cohort study of 76 patients undergoing total or completion thyroidectomy was performed. Serum PTH level was measured 4–12 hours postoperatively and used to stratify patients into three groups: normal PTH (> 12 pg/mL), undetectable PTH (< 3 pg/mL) and intermediate PTH (4–11pg/mL). A subgroup analysis was performed on a cohort of patients after a change in the management philosophy aiming for day 1 discharge based on the postoperative PTH.
Results: Seventy-five percent of eligible patients were successfully discharged on day 1 with no complications or readmissions; 21% of patients had intermediate or undetectable PTH levels and were monitored for 48 hours. No patient required intravenous calcium and no patient suffered permanent hypoparathyroidism.
Conclusion: A single PTH measurement at 4–12 hours postoperatively allows for accurate prediction of patients at risk of hypocalcaemia. Patients with a normal postoperative PTH level can be safely discharged on the first postoperative day. |
| first_indexed | 2024-12-11T16:44:59Z |
| format | Article |
| id | doaj.art-5bc2f83707f0443f8e0a4823c11bde69 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-12-11T16:44:59Z |
| publishDate | 2007-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-5bc2f83707f0443f8e0a4823c11bde692022-12-22T00:58:13ZengElsevierAsian Journal of Surgery1015-95842007-07-0130317818210.1016/S1015-9584(08)60019-6Early Postoperative PTH Levels as a Predictor of Hypocalcaemia and Facilitating Safe Early Discharge After Total ThyroidectomySimon GrodskiStephen FarrellHypocalcaemia after total or completion thyroidectomy has traditionally required 48 hours or longer inpatient monitoring of serum calcium levels. The use of parathyroid hormone (PTH) levels to predict postoperative hypocalcaemia is well established. This study aimed to measure the impact of a management plan based on postoperative PTH on achieving safe early discharge after thyroidectomy. Methods: A prospective cohort study of 76 patients undergoing total or completion thyroidectomy was performed. Serum PTH level was measured 4–12 hours postoperatively and used to stratify patients into three groups: normal PTH (> 12 pg/mL), undetectable PTH (< 3 pg/mL) and intermediate PTH (4–11pg/mL). A subgroup analysis was performed on a cohort of patients after a change in the management philosophy aiming for day 1 discharge based on the postoperative PTH. Results: Seventy-five percent of eligible patients were successfully discharged on day 1 with no complications or readmissions; 21% of patients had intermediate or undetectable PTH levels and were monitored for 48 hours. No patient required intravenous calcium and no patient suffered permanent hypoparathyroidism. Conclusion: A single PTH measurement at 4–12 hours postoperatively allows for accurate prediction of patients at risk of hypocalcaemia. Patients with a normal postoperative PTH level can be safely discharged on the first postoperative day.http://www.sciencedirect.com/science/article/pii/S1015958408600196hypocalcaemiaparathyroid hormoneserum calciumthyroidectomy |
| spellingShingle | Simon Grodski Stephen Farrell Early Postoperative PTH Levels as a Predictor of Hypocalcaemia and Facilitating Safe Early Discharge After Total Thyroidectomy Asian Journal of Surgery hypocalcaemia parathyroid hormone serum calcium thyroidectomy |
| title | Early Postoperative PTH Levels as a Predictor of Hypocalcaemia and Facilitating Safe Early Discharge After Total Thyroidectomy |
| title_full | Early Postoperative PTH Levels as a Predictor of Hypocalcaemia and Facilitating Safe Early Discharge After Total Thyroidectomy |
| title_fullStr | Early Postoperative PTH Levels as a Predictor of Hypocalcaemia and Facilitating Safe Early Discharge After Total Thyroidectomy |
| title_full_unstemmed | Early Postoperative PTH Levels as a Predictor of Hypocalcaemia and Facilitating Safe Early Discharge After Total Thyroidectomy |
| title_short | Early Postoperative PTH Levels as a Predictor of Hypocalcaemia and Facilitating Safe Early Discharge After Total Thyroidectomy |
| title_sort | early postoperative pth levels as a predictor of hypocalcaemia and facilitating safe early discharge after total thyroidectomy |
| topic | hypocalcaemia parathyroid hormone serum calcium thyroidectomy |
| url | http://www.sciencedirect.com/science/article/pii/S1015958408600196 |
| work_keys_str_mv | AT simongrodski earlypostoperativepthlevelsasapredictorofhypocalcaemiaandfacilitatingsafeearlydischargeaftertotalthyroidectomy AT stephenfarrell earlypostoperativepthlevelsasapredictorofhypocalcaemiaandfacilitatingsafeearlydischargeaftertotalthyroidectomy |