Early Prediction of Oral Calcium and Vitamin D Requirements in Post‐thyroidectomy Hypocalcaemia

Aldhahri, Saleh; Mubasher, Mohamed; Almuhawas, Fida; Alessa, Mohammed; Terkawi, Rayan S.; Terkawi, Abdullah Sulieman

doi:10.1177/0194599814536848

Cited by 13 publications

(12 citation statements)

References 20 publications

(43 reference statements)

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“…This percentage, however, is less than the prevalence rates published in the literature and in a previous report published by our group for temporary hypocalcemia following thyroidectomy. 1,11 The lower prevalence of hypocalcemia in the present study could be attributed to the use of prophylactic supplements. The use of a prophylactic postoperative calcium supplement + vitamin D (1,25 dihydroxyvitamin D) has been shown to decrease the incidence of hypocalcemia, and many institutions have adopted this practice with good outcomes.…”

Section: Characteristicmentioning

confidence: 60%

“…[12][13][14][15][16] Previously, we extrapolated/correlated future calcium levels from PTH levels in the first hour following surgery. 11 In this paper, we draw on the work of Dr. David Terris 8,16, aiming once again to identify the percentage of patients in our cohort who would develop hypocalcemia with the inclusion of calcium and vitamin D supplements when included as a routine regimen.…”

Section: Characteristicmentioning

confidence: 99%

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Safety and cost-effectiveness of outpatient thyroidectomy

Alessa

Al‐Angari

Jomah

et al. 2021

SMJ

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To investigate the safety and cost-effectiveness of outpatient thyroidectomy and provide a systematic postoperative protocol for safe discharge. Methods: In this retrospective review, the medical records of all patients who underwent total, hemi, or completion thyroidectomy from July 2017 to April 2019 at 2 tertiary care hospitals were reviewed. Multivariable analysis was performed on the potential predictors of postoperative complications. Healthcare costs were calculated by the type of admission based on the average costs at the 2 centers. Results: One hundred twenty-two patients were enrolled in this study. The majority of cases were in the outpatient group (n=76, 62.3%). Total Original Article thyroidectomy was the most prevalent type of surgery (n=90, 73.7%). There were a total of 20 complications in 18 patients (inpatient=9 versus [vs.] outpatient=9). No cases of cervical hematoma or bilateral vocal cord paralysis were encountered. No significant difference was found between the type of admission (outpatient vs. inpatient) and postsurgical complications (p=0.24). The multivariable regression model retained significance for male gender and American Society of Anesthesiologists Classification III as potential predictors of postoperative complications. Healthcare costs would be reduced by at least 15.5% with the implementation of outpatient surgery. Conclusion: Outpatient thyroidectomy is as safe as inpatient thyroidectomy given the proper selection of cases. We project cost containment of over $711 thousand per 1,000 cases for outpatient thyroid surgeries.

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Section: Characteristicmentioning

confidence: 60%

Section: Characteristicmentioning

confidence: 99%

Safety and cost-effectiveness of outpatient thyroidectomy

Alessa

Al‐Angari

Jomah

et al. 2021

SMJ

Self Cite

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“…Several recent studies have recognised vitamin D deficiency as a risk factor for post-thyroidectomy hypocalcaemia and the importance of vitamin D status in directing post-thyroidectomy hypocalcaemia management. 7 , 8 , 9 , 10 , 11 This interest is driven by the impact of post-thyroidectomy hypocalcaemia on patients’ postoperative quality of life, and by the financial burden imposed by hypocalcaemia on patients and the health care system 12 , 13 ; it has been reported that the median hospital stay increases by 51.5 h if the patient develops hypocalcaemia, and the estimated cost of bed utilisation in a local hospital is $23US per hour. 12…”

Section: Introductionmentioning

confidence: 99%

Seasonal variations in serum levels of vitamin D and other biochemical markers among KSA patients prior to thyroid surgery

Aldrees

Alohali

Albosaily

et al. 2020

Journal of Taibah University Medical Sciences

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Objectives Serum levels of vitamin D can vary between seasons, which may affect serum calcium levels in post-thyroidectomy patients. This study aimed to determine seasonal variations in serum levels of vitamin D and other biochemical markers in patients prior to thyroid surgery in a KSA hospital. Methods In this study, we analysed the data of 685 post-thyroidectomy patients. The preoperative laboratory values of all patients were collected, and the patients were categorized into groups based on the month when the surgical procedure was performed as follows: cold (November–February) and warm/hot groups (March–October). Results Serum vitamin D levels were deficient in 70% of the patients, insufficient in 18%, and optimal in 12%. The mean age of patients in the deficient group was significantly lower than that in the optimal group. There were significantly more patients who had vitamin D deficiency during the cold season than during the warm/hot season ( p = 0.024). Serum vitamin D levels did not vary between seasons ( p = 0.836); however, the preoperative magnesium and thyroid stimulating hormone (TSH) levels were significantly higher during the warm/hot season than during the cold season ( p = 0.039 and p < 0.001, respectively). Preoperative calcium level was not significantly different between the cold and warm/hot months ( p = 0.282). Conclusion This study suggests a non-significant seasonal fluctuation in serum levels of vitamin D with insignificant variation in serum calcium levels during cold and warm/hot seasons. The findings necessitate a careful review of the patients’ biochemical status prior to surgery. Future prospective longitudinal studies are needed to confirm this variability.

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“…Traditionally, postthyroidectomy hypocalcaemia is diagnosed by means of either total or ionized serum calcium assessments every 6 to 12 hours. Postthyroidectomy levels of intact parathyroid hormone (PTH) have been utilized in order to predict the presence and severity of postoperative hypocalcaemia, thus leading to better management strategies . However, no consensus regarding timing of measurement, diagnostic accuracy, and cost‐effectiveness has been reached among surgeons in this field.…”

Section: Introductionmentioning

confidence: 99%

Postoperative day 1 levels of parathyroid as predictor of occurrence and severity of hypocalcaemia after total thyroidectomy

et al. 2018

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Early Prediction of Oral Calcium and Vitamin D Requirements in Post‐thyroidectomy Hypocalcaemia

Abstract: Our findings help to optimize management of post-thyroidectomy hypocalcemia by assisting in the early identification of those who are not at risk of hypocalcaemia and by guiding early effective management of those at risk. This may reduce complications and medical cost.

Cited by 13 publications

References 20 publications

Safety and cost-effectiveness of outpatient thyroidectomy

Safety and cost-effectiveness of outpatient thyroidectomy

Seasonal variations in serum levels of vitamin D and other biochemical markers among KSA patients prior to thyroid surgery

Postoperative day 1 levels of parathyroid as predictor of occurrence and severity of hypocalcaemia after total thyroidectomy

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