Identificazione dei pazienti ad alto rischio di ipocalcemia dopo tiroidectomia totale

Translated title of the contribution: Identification of patients at high risk for hypocalcemia after total thyroidectomy

P. Tredici, E. Grosso, B. Gibelli, M. A. Massaro, C. Arrigoni, N. Tradati

Research output: Contribution to journalArticlepeer-review

Abstract

Hypocalcemia is a major post-operative complication of total thyroidectomy, causing severe symptoms and increasing hospitalization time. The primary cause is secondary hypo-parathyroidism following damage to, or devascularisation of, one or more parathyroid glands during surgery. Aim of the study was to develop a simple and reliable method for predicting post-operative hypocalcemia in total thyroidectomy patients. A retrospective analysis was made of immediate pre-operative and early post-operative calcium levels in 100 patients. It was found that a marked decrease in blood calcium, immediately after surgery, was a sensitive predictor of hypocalcemia. In a subsequent prospective series of 67 patients, the efficacy was assessed of early administration of calcium plus Vitamin D in reducing symptomatic hypocalcemia in patients in whom the difference (Δ) between pre- and post-operative blood calcium was ≥ 1.1 mg/dl. This treatment was part of a protocol in which normo-calcemic patients were discharged immediately after drainage removal (third post-operative day). In the retrospective series, 84% of patients who developed hypocalcemia had Δ ≥ 1.1 and 54% of patients who did not develop hypocalcemia had Δ <1.1 (p <0.0001). Mean duration of hospitalization was 6.2 days. In the prospective series, 76% of patients who developed hypocalcemia had Δ ≥ 1.1 mg/dl; of the patients who did not develop hypocalcemia 75% had Δ <1.1 mg/dl (p = 0.0013); mean hospitalization was 4.7 days (p <0.0001). Use of the 1.1 mg/dl cut-off for deciding whether to start early prophylaxis allowed most patients to avoid symptomatic hypocalcemia (and the associated anxiety), while permitting a significantly reduced hospital stay, resulting in lower hospitalization costs.

Translated title of the contributionIdentification of patients at high risk for hypocalcemia after total thyroidectomy
Original languageItalian
Pages (from-to)144-148
Number of pages5
JournalActa Otorhinolaryngologica Italica
Volume31
Issue number3
Publication statusPublished - Jun 2011

ASJC Scopus subject areas

  • Otorhinolaryngology

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