A symptom-based algorithm for calcium management after thyroid surgery: a prospective multicenter study
Main finding · Treated with calcium and/or alfacalcidolResult — go to the resultOdds ratio 0.36 95% CI 0.23–0.54Authors' conclusion
Symptom-based management of postthyroidectomy hypocalcemia and a protocolized attempt to phase out supplementation safely reduced the proportion of patients receiving supplementation, although the number of calcium-related hospital visits increased. For the future, we envision a more individualized treatment approach for patients at risk for delayed symptomatic hypocalcemia, including the proportional change in pre- to post- operative PTH.
Study context
- Population
- Patients after thyroidectomy (postthyroidectomy hypocalcemia management)
- Participants
- 134 vs 392
- Exposure
- Symptom-based treatment algorithm vs biochemically based approach
- New algorithmn = 134
- Historicaln = 392reference
- Outcome
- Proportion of patients receiving calcium and/or alfacalcidol supplementation
- Follow-up
- First postoperative year
Methodological detailsmulticenter, historical cohort comparison
- Multicenter
- Historical cohort comparison
Main finding
Treated with calcium and/or alfacalcidol
Odds ratio
0.36
95% CI 0.23–0.54
P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Treated with calcium and/or alfacalcidol · 12 months follow-up | 0.51 (0.28–0.90) | P < 0.05 | |
| 0.20.5125Odds ratio (log scale) |
Predictor for supplementation: proportional change in pre- to postoperative parathyroid hormone (PTH)
- Independent predictor, OR (95% CI 1.02-1.07), P < 0.05
- 1.04
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Calcium-related complicationsNew algorithmvs HistoricalCalcium-related ED visits | 11.5 (4.51–29.3) | P < 0.001 | |
| Calcium-related complicationsNew algorithmvs HistoricalReadmissions | 3.46 (1.58–7.57) | P < 0.05 | |
| 0.050.21520Odds ratio (log scale) |
- Calcium-related complications — Severe calcium-related complications
- 0
Original publication
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