Post-operative pth measurement facilitates day 1 discharge after total thyroidectomy.

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Post-operative PTH measurement facilitates day 1 discharge after total thyroidectomy.
Clin Endocrinol (Oxf). 2008 Jun 20;
Authors: Grodski S, Lundgren CI, Sidhu S, Sywak M, Delbridge L
Objective: A new protocol for post-operative calcium management was developed with the aim of achieving an increase in the proportion of patients being safely discharged on the first post-operative 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 parathyroid hormone (iPTH) was measured at 4-hours post-operatively and patients with iPTH in the normal range were discharged on the first post-operative day. Results: Mean age and sex distribution were similar in both groups. Mean lowest post-operative corrected calcium levels in the study group were 2.19mmol/L and 2.15mmol/L in the control group(P=0.24). Parathyroid auto-transplantaion was associated with low PTH levels (risk ratio=0.49). Over 50% of patients (n=27) were successfully discharged on the first post-operative day in the study group and no patient required readmission. Length of stay was significantly shorter in the study group, mean 1.64 days 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.
PMID: 18573120 [PubMed - as supplied by publisher] (Source: Clinical Endocrinology)  MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.