ArticleWorld journal of surgery2013
How useful are perioperative biochemical parameters in predicting the duration of calcium and/or vitamin D supplementation after total thyroidectomy?
Article in World journal of surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Diagnosis and treatment of hypoparathyroidism: a position statement from the Brazilian Society of Endocrinology and Metabolism.Archives of endocrinology and metabolism · 2018Guideline
- The Influence of Prophylactic Calcium and Magnesium Supplementation on Postoperative Quality of Life and Hypocalcemia After Total Thyroidectomy: Study Protocol for a Randomized Controlled Trial.Frontiers in surgery · 2021Article
- The Association of Discolored Parathyroid Glands and Hypoparathyroidism Following Total Thyroidectomy.World journal of surgery · 2016Article
- Visualizing fewer parathyroid glands may be associated with lower hypoparathyroidism following total thyroidectomy.Langenbeck's archives of surgery · 2016Article
- Evaluating the Incidence, Cause, and Risk Factors for Unplanned 30-Day Readmission and Emergency Department/General Practitioner Visit After Short-Stay Thyroidectomy.World journal of surgery · 2016Article
- [Surgical assessment of complications after thyroid gland operations].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2015Review
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Authors and funding
2 authors at 2 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundOral calcium and calcitriol are often prescribed after total thyroidectomy to avoid biochemical and/or symptomatic hypocalcemia. We aimed to identify independent perioperative factors that correlated with the duration of calcium and/or calcitriol supplementation after total thyroidectomy.
methodsOf 271 eligible patients, 48 (17.7 %) required calcium and/or calcitriol supplements on discharge. Patients were gradually weaned from the supplementation by one surgeon according to a biweekly algorithm based on serum calcium (Ca). Duration of supplementation was calculated from the date of operation to the date of ceasing all supplementation without biochemical hypocalcemia (i.e., serum adjusted Ca ≥ 8.44 mg/dL). The Cox regression analysis was performed to identify independent perioperative factors for duration of supplementation. The best cut-off value for these independent factors was determined by the receiver characteristic curve.
resultsIn the multivariate analysis, parathyroid hormone (PTH) at skin closure (PTH-SC) (RR 1.742, 95 % CI 1.080-2.810) and on postoperative day 1 adjusted Ca (Ca-D1) (RR 77.526, 95 % CI 3.600-1669.57) were the only two independent determinants for shorter duration before ceasing all supplementation. The best cut-off values in predicting supplementation ≥ 6 months for PTH-SC and Ca-D1 were 7.08 pg/mL (sensitivity = 100 %, specificity = 60.5 %, PPV = 40.0 % and NPV = 100 %) and 7.88 mg/dL (sensitivity = 90.0 %, specificity = 55.3 %, PPV = 34.6 % and NPV = 95.5 %), respectively.
conclusionsBoth PTH-SC and Ca-D1 were independently associated with the duration of supplementation after total thyroidectomy. Almost all patients with PTH-SC ≥ 7.08 pg/mL or Ca-D1 ≥ 7.88 mg/dL did not require supplementation ≥ 6 months whereas about one third of patients with PTH-SC <7.08 pg/mL or Ca-D1 <7.88 mg/dL required supplementation ≥ 6 months.
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