A Parathyroid Hormone–Guided Calcium and Calcitriol Supplementation Protocol Reduces Hypocalcemia-Related Readmissions Following Total Thyroidectomy
Authors' conclusion
Compared with a historical cohort, a PTH-guided protocol for Ca and calcitriol supplementation significantly reduces the postoperative hypocalcemia and hospital readmission rates in patients undergoing total thyroidectomy.
Study context
- Population
- Patients undergoing total thyroidectomy, single institution
- Participants
- 389 vs 148
- Exposure
- 4-hour postoperative parathyroid hormone (PTH)-guided calcium (Ca) and calcitriol supplementation protocol vs preprotocol care
- Protocoln = 389
- Preprotocoln = 148reference
- Outcome
- Incidence of hypocalcemia (total serum Ca <8 mg/dL) and hospital readmissions
Methodological detailssingle-institution, retrospective chart review, historical cohort comparison, multivariate logistic regression, Hypocalcemia risk stratified by 4-h PTH: low >30 pg/mL, medium 15-30 pg/mL, high <15 pg/mL
- Single-institution
- Retrospective chart review
- Historical cohort comparison
- Multivariate logistic regression
- Hypocalcemia risk stratified by 4-h PTH: low >30 pg/mL, medium 15-30 pg/mL, high <15 pg/mL
Main finding
As reported in the abstract
Postoperative hypocalcemia
P = 0.002
Observational data: associations, not effects.
Further findings
Hospital readmission · significantly lower with protocol
P = 0.013
Hypocalcemia, with cervical lymph node dissection
Hypocalcemia, without cervical lymph node dissection
Original publication
A Parathyroid Hormone–Guided Calcium and Calcitriol Supplementation Protocol Reduces Hypocalcemia-Related Readmissions Following Total Thyroidectomy. Endocr Pract. Published 20 January 2023. doi:10.
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