Early hospital discharge through prediction of post-thyroidectomy hypoparathyroidism.

Autor: Galindo Fernández A; Servicio de Otorrinolaringología y Cirugía de Cabeza de Cuello, Hospital General Universitario Los Arcos del Mar de Menor, Pozo Aledo, Murcia, Spain; Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos n°135, Guadalupe, 30107, Murcia, Spain. Electronic address: antoniogalindofernandez@gmail.com., Giribet Fernández-Pacheco A; Servicio de Otorrinolaringología y Cirugía de Cabeza de Cuello, Hospital General Universitario Los Arcos del Mar de Menor, Pozo Aledo, Murcia, Spain., Fages Cárceles N; Servicio de Otorrinolaringología y Cirugía de Cabeza de Cuello, Hospital General Universitario Los Arcos del Mar de Menor, Pozo Aledo, Murcia, Spain., Espinosa Fernández L; Servicio de Otorrinolaringología y Cirugía de Cabeza de Cuello, Hospital General Universitario Los Arcos del Mar de Menor, Pozo Aledo, Murcia, Spain., Molina Moreno A; Servicio de Otorrinolaringología y Cirugía de Cabeza de Cuello, Hospital General Universitario Los Arcos del Mar de Menor, Pozo Aledo, Murcia, Spain., García-Purriños García FJ; Servicio de Otorrinolaringología y Cirugía de Cabeza de Cuello, Hospital General Universitario Los Arcos del Mar de Menor, Pozo Aledo, Murcia, Spain; Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos n°135, Guadalupe, 30107, Murcia, Spain.
Jazyk: angličtina
Zdroj: Acta otorrinolaringologica espanola [Acta Otorrinolaringol Esp (Engl Ed)] 2024 Jul-Aug; Vol. 75 (4), pp. 238-243. Date of Electronic Publication: 2024 Mar 01.
DOI: 10.1016/j.otoeng.2023.12.003
Abstrakt: Introduction: Hypoparathyroidism is the most common postsurgical complication of total thyroidectomy. Furthermore, it is the main cause of prolonged hospitalisation after this procedure.
Objective: To predict the probability of post-thyroidectomy hypocalcaemia according to the levels of intact parathyroid hormone (iPTH), as well as to determine the needs for treatment with exogenous calcium according to the levels of serum calcium (Ca).
Materials and Methods: Retrospective study was carried out on patients who underwent total thyroidectomy between January 2017 and January 2020 at Los Arcos del Mar Menor University Hospital (HULAMM). iPTH and Ca levels ​​were measured at 4, 24 and 48 h after the surgery. Follow-up was 6 months.
Results: Ninety-four patients were operated on. Temporary and permanent postoperative hypoparathyroidism percentages were, respectively, 51.06% and 6.38%. iPTH level 24 h after the procedure was the most reliable predictor of post-thyroidectomy temporary hypoparathyroidism (Area Under the ROC Curve (AUC) = 0.933, p < .001). iPTH levels ​​≥29 pg/mL predicted normal parathyroid metabolism.
Conclusions: The combined values of iPTH and Ca levels 24 h after thyroidectomy seems to be a reliable, safe and efficient method to control the post-thyroidectomy hypoparathyroidism. Our protocol could reduce the hospital stay of patients at low risk of hypocalcaemia, allowing them to be discharged from the hospital on the first postoperative morning and identifying patients at high risk of hypocalcaemia early.
(Copyright © 2024 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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