Cost savings associated with post-thyroidectomy parathyroid hormone levels.
OBJECTIVE
A 1-hour post-thyroidectomy parathyroid hormone (PTH) level of < or =8 ng/L is predictive of patients who will develop hypocalcemia and guides early supplementation with calcium and vitamin D. However, most hypocalcemic patients fail to meet this criterion. The goal of this study was to determine whether PTH < or = 15 ng/L could be used as a better predictor of hypocalcemia. STUDY DESIGN, SUBJECTS, AND METHODS: This retrospective study involved 270 thyroidectomy patients (2004-2006). PTH and calcium levels, length of admission, supplementation, and rates of hypocalcemia were recorded.


RESULTS
Forty-three percent (26/60) of patients developing hypocalcemia met the PTH < or = 8 ng/L cut-off. In contrast, 80% (48/60) of patients developing hypocalcemia had a PTH < or = 15 ng/L. Two point two percent of patients had a 1-hour PTH < or = 15 ng/L and failed to develop hypocalcemia, for a specificity of 97%.


CONCLUSIONS
A 1-hour PTH cut-off of < or =15 ng/L for prophylactic supplementation should allow the prevention of the majority of cases of hypocalcemia, leading to significant cost savings by shortening hospital stays.
Cote
Valerie
V
Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada.
Sands
Noah
N
Hier
Michael P
MP
Black
Martin J
MJ
Tamilia
Michael
M
MacNamara
Elizabeth
E
Zhang
Xun
X
Payne
Richard J
RJ
D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002117:Calcitriol / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D017046:Cost Savings; D005260:Female; D017721:Hospital Costs / Q000639:trends*; D006801:Humans; D006996:Hypocalcemia / Q000097:blood* / Q000191:economics / Q000517:prevention & control; D007118:Immunoassay; D007902:Length of Stay / Q000191:economics / Q000639:trends; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000191:economics / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects* / Q000191:economics
D050071:Bone Density Conservation Agents; D010281:Parathyroid Hormone; D002117:Calcitriol; D002118:Calcium