Improving safety in paediatric thyroidectomy by PTH measurements

FREIRE, ANALÍA V.; ROPELATO, MARÍA G.; PAPENDIECK, PATRICIA; VIEITES, ANA; ELÍAS, EUGENIA; BALLERINI, MARIA G.; RODRIGUEZ, MARÍA E.; BERGADÁ, IGNACIO; CHIESA, ANA

CLINICAL ENDOCRINOLOGY

WILEY-BLACKWELL PUBLISHING, INC

Año: 2021

0300-0664

Objetive: We followed our previously reported algorithm based on intra and postoperative parathyroid hormone (PTH) levels to predict postthyroidectomy hypoparathyroid hypocalcemia. The objective of the study was to assess if this strategy is useful and safe to reduce hypocalcemia, hospitalisation length and postsurgery calcium sampling. Design, Patients, Meassurements: We classified our series of 66 patients according to their risk of hypoparathyroidism based on PTH determinations. We treated high-risk patients with calcium and vitamin D1?25 supplementation and obtained routine daily calcium samples to control low-risk patients until 48 h postsurgery. We compared the outcomes and overall results of this new approach with those of a historical control group of patients with equivalent PTH measurements who were treated only if they presented hypocalcemia. Results: In the high-risk subgroup (n = 30), five patients had hypocalcemia within the first 24 h. Compared with the high-risk control subgroup, the incidence of hypocalcemia fell from 100% to 17% (p