title: Calcium management after thyroidectomy: a simple and cost-effective method.
abstract: OBJECTIVE
  Hypocalcemia is one of the principal complications of total or completion thyroidectomy. A number of different protocols for managing this potential complication have been published. Our simple postoperative regimen is described and the safety and cost-effectiveness assessed.
  
  
  METHODS
  Case series with planned data collection.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  All patients undergoing total or completion thyroidectomy from January 2008 through June 2010 were evaluated. Data collected included age; gender; procedure performed; levels of ionized calcium, parathyroid hormone, and vitamin D; complications; and need for readmission. Standard descriptive statistics were used to summarize these data.
  
  
  RESULTS
  In total, 526 patients had thyroid surgery during the 30-month study period. Of these, 307 underwent completion or total thyroidectomy and were prescribed a 3-week tapering course of calcium carbonate postoperatively. Twenty-three patients (7.5%) experienced symptoms of hypocalcemia that were managed on an outpatient basis with additional doses of oral calcium. Two patients (0.7%) required readmission. The cost of a 3-week regimen of calcium carbonate is approximately $15. This is considerably less expensive than either the cost of overnight admission or published laboratory protocols that are designed to predict the risk of hypocalcemia.
  
  
  CONCLUSIONS
  Prophylactic calcium supplementation without routine laboratory assessment proved to be a safe and cost-effective method of preventing and managing postoperative hypocalcemia following total or completion thyroidectomy.
authors.affiliation: Georgia Health Sciences University, Augusta, Georgia 30912-4060, USA. msinger@georgiahealth.edu
authors.forename: Michael C
authors.initials: MC
authors.lastname: Singer
authors.forename: Dimpal
authors.initials: D
authors.lastname: Bhakta
authors.forename: Melanie W
authors.initials: MW
authors.lastname: Seybt
authors.forename: David J
authors.initials: DJ
authors.lastname: Terris
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D002118:Calcium / Q000008:administration & dosage* / Q000191:economics; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006996:Hypocalcemia / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage* / Q000191:economics
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; D002118:Calcium