Cost savings associated with post‐thyroidectomy parathyroid hormone levels
Abstract
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.
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Low iPTH levels (<10-15 pg/mL) in the immediate postoperative setting appear to predict symptomatic hypocalcemia and need for calcium and calcitriol supplementation.
“Low iPTH levels (<10-15 pg/mL) in the immediate postoperative setting appear to predict symptomatic hypocalcemia and need for calcium and calcitriol (1,25 vitamin D) supplementation (212,213).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [213]
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- Authors
- Cote, V., Sands, N., Hier, M. P., Black, M. J., Tamilia, M., MacNamara, E., Zhang, X., & Payne, R. J.
- Affiliations
- Department of Otolaryngology–Head and Neck Surgery Jewish General Hospital McGill University Montreal QC Canada
- Jewish General Hospital (CA)
- Montreal Children's Hospital (CA)
- Venue
- Otolaryngology–Head and Neck Surgery
- Publisher
- Wiley
- Published
- 2008-02
- Volume
- 138
- Issue
- 2
- Pages
- 204-208
- ISSN
- 0161-6439 (ISSN-L)
- 0194-5998
- 1097-6817
- OpenAlex
- W2094030052
- Cited by
- 32
- References
- 21
- Citations by year
- 2022: 2 · 2020: 3 · 2019: 1 · 2017: 2 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 4 · 2012: 2
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Otolaryngology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Keywords
- parathyroid hormone, thyroidectomy, postoperative hypocalcemia, hypocalcemia prediction, calcium and vitamin D supplementation, length of hospital stay, healthcare cost reduction
- MeSH terms
- Calcitriol, Calcium, Female, Humans, Hypocalcemia, Immunoassay, Length of Stay, Male, Middle Aged, Parathyroid Hormone, Prognosis, Retrospective Studies, Risk Factors, ROC Curve, Thyroid Neoplasms, Thyroidectomy, Cost Savings, Hospital Costs, Bone Density Conservation Agents
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