Serum calcium slope predicts hypocalcaemia following thyroid surgery.
BACKGROUND
Hypocalcaemia is the single commonest complication of thyroid surgery. Typically, serial calcium levels are performed post-operatively in order to detect hypocalcaemia, often requiring at least a 48-h stay. Our practice is to measure serum corrected calcium pre-operatively, 6 h post-operatively and 24 h post-operatively. Patients are discharged if they have a normal serum calcium value at 24 h.


METHODS
We performed a retrospective review to determine if the calcium slope from pre-operatively to 6 h post-operatively predicts serum calcium levels at 24 h, thus allowing early discharge.


RESULTS
Fifty-two patients who underwent total or subtotal thyroidectomies were studied. Hypocalcaemia developed in 19 patients within 24 h of surgery (serum adjusted calcium less than 2.15 mmol/dL) within 24 h of surgery. There were no significant differences between the hypocalcaemic and normocalcaemic groups with respect to Graves' disease (p=0.17), total thyroidectomy (p=0.39), number of parathyroids identified (p=0.66), or parathyroid autotransplantation (p=0.29). The serum calcium slope from baseline to 6 h post-operatively correlated with serum calcium values at 24 h (p=0.008).


CONCLUSIONS
Serum calcium slope may be useful in identifying patients suitable for early discharge following thyroid surgery.
Walsh
Stewart R
SR
Department of General Surgery, West Suffolk Hospital NHS Trust, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, UK.
Kumar
Belindra
B
Coveney
Eamonn C
EC
D000328:Adult; D002118:Calcium; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D011182:Postoperative Care; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects*
D002118:Calcium