Serum calcium slope predicts hypocalcaemia following thyroid surgery☆
published online 26 May 2006.
Abstract
Background
Hypocalcaemia is the single commonest complication of thyroid surgery. Typically, serial calcium levels are performed post-operatively in order to detect hypocalcaemia, often requiring at least a 48-h stay. Our practice is to measure serum corrected calcium pre-operatively, 6h post-operatively and 24h post-operatively. Patients are discharged if they have a normal serum calcium value at 24h.
Methods
We performed a retrospective review to determine if the calcium slope from pre-operatively to 6h post-operatively predicts serum calcium levels at 24h, thus allowing early discharge.
Results
Fifty-two patients who underwent total or subtotal thyroidectomies were studied. Hypocalcaemia developed in 19 patients within 24h of surgery (serum adjusted calcium less than 2.15mmol/dL) within 24h of surgery. There were no significant differences between the hypocalcaemic and normocalcaemic groups with respect to Graves' disease (p=0.17), total thyroidectomy (p=0.39), number of parathyroids identified (p=0.66), or parathyroid autotransplantation (p=0.29). The serum calcium slope from baseline to 6h post-operatively correlated with serum calcium values at 24h (p=0.008).
Conclusion
Serum calcium slope may be useful in identifying patients suitable for early discharge following thyroid surgery.
Department of General Surgery, West Suffolk Hospital NHS Trust, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, UK
Corresponding author. Tel./fax:+44 1284 713482.
☆ Presented to the Association of Surgeons of Great Britain and Ireland June 2004 and published in abstract form in British Journal of Surgery 2004; 91 (Supplement 1): 52.
ABSTRACT