Impact of outcomes data on the management of postoperative hypocalcemia in head and neck endocrine surgery patients
| Autor: | Joshua D. Waltonen, Hafiz S. Patwa, Thomas H. Fitzpatrick, J. Dale Browne, Marcus J. Magister, Christopher A. Sullivan, Brittany B. Henderson |
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| Rok vydání: | 2020 |
| Předmět: |
Parathyroidectomy
Adult Male medicine.medical_specialty Tetany medicine.medical_treatment Parathyroid hormone 03 medical and health sciences 0302 clinical medicine Postoperative Complications Internal medicine medicine Vitamin D and neurology Humans Vitamin D 030223 otorhinolaryngology Aged Retrospective Studies Completion thyroidectomy Hypocalcemia business.industry Emergency department Middle Aged medicine.disease Prognosis Endocrine surgery Otorhinolaryngology Hypoparathyroidism 030220 oncology & carcinogenesis Thyroidectomy Calcium Female medicine.symptom business |
| Zdroj: | American journal of otolaryngology. 41(4) |
| ISSN: | 1532-818X |
| Popis: | Postoperative hypocalcemia is a well-described outcome following thyroid and parathyroid surgery with symptoms ranging from clinically insignificant laboratory findings to tetany and seizures. The aims of this study were 1. To identify the characteristics and management patterns of postoperative hypocalcemia in head and neck endocrine surgery patients and 2. To compare outcomes between patients treated with empiric calcium and patients treated using a biochemically driven calcium replacement algorithm. Clinical electronic medical record (EMR) data was collected from patients who had undergone total thyroidectomy, completion thyroidectomy, and/or parathyroidectomy at Wake Forest Baptist Medical Center (WFBMC), a tertiary referral and academic institution. Between July 1, 2016, and June 30, 2017, 298 adult patients underwent surgery by a WFBMC Head & Neck (H&N) endocrine surgeon. Objective calcium and parathyroid hormone levels, postoperative supplementation with calcium and Vitamin D, 30-day physician access line (PAL) phone call utilization, emergency department (ED) encounters, and readmission rates were queried. The overall rate of hypocalcemia was 17.4%. No statistically significant difference in PAL utilization, ED visits, or readmissions was found between the empiric supplementation group and those whose supplementation was biochemically directed (PAL 5.0% vs. 5.0% [p = 0.983], ED visit 3.3% vs. 2.5% [p = 0.744], Readmission 1.7% vs. 0% [p = 0.276]). The overall postoperative rates of hypocalcemia and hypoparathyroidism following H&N endocrine surgery were consistent with the reported literature. Neither method of calcium supplementation was superior in reducing PAL utilization, ED encounters, or readmission. |
| Databáze: | OpenAIRE |
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