Predicting calcium status post thyroidectomy with early calcium levels.
OBJECTIVE
The study goals were to predict postoperative normocalcemia and hypocalcemia after total thyroidectomy using calcium levels and to assess the value of a standardized protocol in managing the total thyroidectomy patient.


METHODS
We conducted a prospective study encompassing 68 patients undergoing a total thyroidectomy using a standardized protocol. Blood to measure postoperative calcium levels was drawn at 6, 12, and 20 hours and then twice daily thereafter. Calcium slope was calculated from the 6- and 12-hour serum corrected calcium levels.


RESULTS
Logistic regression analysis allowed the comparison of the 6- and 12-hour calcium slope versus proportion of normocalcemic patients postoperatively. A slope of +0.02 had a 97% chance of remaining normocalcemic (p = 0.0007).


CONCLUSIONS
Successful prediction of calcium status post total thyroidectomy can be achieved using the slope of the 6- and 12-hour calcium levels. The risk of developing severe hypocalcemia can also be predicted with these slope values. Implementation of the protocol resulted in a significant reduction in the duration of hospital stay for patients who remain normocalcemic.
Husein
Murad
M
Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Canada.
Hier
Michael P
MP
Al-Abdulhadi
Khaled
K
Black
Martin
M
D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis* / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D013997:Time Factors
D002118:Calcium