Document Detail


Postoperative PTH measurement facilitates day 1 discharge after total thyroidectomy.
MedLine Citation:
PMID:  18573120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: A new protocol for postoperative calcium management was developed with the aim of achieving an increase in the proportion of patients being safely discharged on the first postoperative day. We present our experience with the first 50 patients treated under this new protocol. PATIENTS AND DESIGN: A cohort study was performed involving the first 50 patients admitted for total or completion thyroidectomy, those data were then compared with a control group. Intact PTH (iPTH) was measured at 4-h postoperatively and patients with iPTH in the normal range were discharged on the first postoperative day. RESULTS: Mean age and sex distribution were similar in both groups. Mean lowest postoperative corrected calcium levels in the study group were 2.19 mmol/l and 2.15 mmol/l in the control group (P = 0.24). Parathyroid auto-transplantation was associated with low PTH levels (risk ratio = 0.49). Over 50% of patients (n = 27) were successfully discharged on the first postoperative day in the study group and no patient required readmission. Length of stay was significantly shorter in the study group, mean 1.64 vs. 2.20 days (P < 0.05). CONCLUSION: The use of iPTH accurately predicts hypocalcaemia after total thyroidectomy and can be used to facilitate safe early discharge for patients.
Authors:
Simon Grodski; Catharina Ihre Lundgren; Stan Sidhu; Mark Sywak; Leigh Delbridge
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Clinical endocrinology     Volume:  70     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-11     Completed Date:  2009-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  322-5     Citation Subset:  IM    
Affiliation:
Endocrine Surgical Unit, University of Sydney, Sydney, Australia. grodski@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Calcium / blood
Cohort Studies
Female
Humans
Hypocalcemia / blood,  diagnosis*,  etiology*
Immunoassay / methods*
Length of Stay
Male
Middle Aged
Parathyroid Hormone / blood*
Patient Discharge*
Postoperative Period
Predictive Value of Tests
Thyroidectomy / adverse effects*
Time Factors
Chemical
Reg. No./Substance:
0/Parathyroid Hormone; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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