Cost savings associated with post-thyroidectomy parathyroid hormone levels
Presented at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, Washington, DC, September 16-19, 2007.
Received 3 September 2007; received in revised form 7 November 2007; accepted 16 November 2007.
Objectives
A 1-hour post-thyroidectomy parathyroid hormone (PTH) level of ≤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 ≤ 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 ≤ 8 ng/L cut-off. In contrast, 80% (48/60) of patients developing hypocalcemia had a PTH ≤ 15 ng/L. Two point two percent of patients had a 1-hour PTH ≤ 15 ng/L and failed to develop hypocalcemia, for a specificity of 97%.
Conclusions
A 1-hour PTH cut-off of ≤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.
aDepartment of Otolaryngology–Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada
bDepartment of Endocrinology, Jewish General Hospital, McGill University, Montreal, QC, Canada
cDepartment of Diagnostic Medicine, Jewish General Hospital, McGill University, Montreal, QC, Canada
dDepartment of Epidemiology and Biostatistics, Montreal Children’s Hospital, McGill University, Montreal, QC, Canada.
Corresponding author: Dr Richard J. Payne, 3755 Cote Ste. Catherine, Suite E903, Montreal, Quebec, Canada H3T 1E2.
ABSTRACT