Morales-Cadena M, Zubiaur-Gomar F

Language: Spanish
References: 8
Page: 29-33
PDF size: 153.57 Kb.

ABSTRACT

Objective. To find out how predictable calcium levels (normocalcemia and hypocalcemia) can be based on serum calcium levels 6 and 12 hours after surgery, as well as to establish a management protocol for patients with thyroid and parathyroid surgery in order to achieve shorter hospital stays. Material and methods. A retrospective study was conducted where 55 consecutive patients where evaluated. Serum calcium levels where registered 6 and 12 hours after surgery and based on the corrected calcium results, logistic regression analysis slopes were used to predict follow-up calcium levels. These results were then compared with the real calcium levels obtained after a 12 hour postoperative period. Results. In patients with slopes greater than + 0.02, calcium levels after a 12 hour postoperative period remained within the normal range. The average number of days of hospital stay for patients with positive slopes (greater than 0) who also remained normocalcemic was three. Patients with abnormal calcium levels where managed in a variety of ways in order to achieve normocalcemia, with an average of 3.6 days of hospital stay for those with negative slopes (less tan 0) and hypocalcemia. Conclusions. Patients who have a high probability of staying normocalcemic could be discharged from the hospital with specific ambulatory instructions one day after surgery. For those with hypocalcemia, a well established and standarized hospital management protocol can be followed, allowing for a shorter hospital stay in this group as well.

REFERENCES

1. Kaplan EL, Sugg SL. Surgery of the thyroid. En: Endocrinology. WB Saunders, Philadelphia, 4th ed., 2001; pp. 1567-84.

2. McHenry CR, Speroff T, Wentworth D. Risk factors for postthyroidectomy hypocalcemia. Surgery 1994; 116:641-8.

3. Demeester-Mirkine N, Hooghe L, Van Geertruyden J. Hypocalcemia after thyroidectomy. Arch Surg 1992;127:854-8.

4. Pattou F, Combemale F, Fabre S. Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg 1998; 22: 718-24.

5. Lo C, Lam K. Postoperative hypocalcemia in patients who did not undergo parathyroid autotransplantation during thyroidectomy: a comparative study. Surgery 1998;124:1081-7.

6. LoGerfo P, Gates R, Gazetas P. Outpatient and shortstay thyroid surgery. Head Neck 1991; 13: 97-101. Marohn MR, LaCivita KA. Evaluation of total/neartotal thyroidectomy in a short stay hospitalization: safe and cost-effective. Surgery 1995; 118: 943-8.

7. Adams J, Andersen P, Everts E. Early postoperative calcium levels as predictors of hypocalcemia. Laryngoscope 1998; 108: 1829-31.

8. 8.-Husein M, Hier M, Al-Adbulhadi, Black M. Predicting calcium status post-thyroidectomy with early calcium levels. Otolaryngol Head Neck Surg 2002; 127: 289-93.