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. Method: Prospective analysis of a consecutive series of patients undergoing thyroid surgery from January 2008 through June 2010 was performed. Data collected included age, gender, procedure performed, levels of ionized calcium, parathyroid hormone, vitamin D, complications, and need for readmission. Standard descriptive statistics were used to summarize this data. Results: A total of 526 patients had thyroid surgery during the 30-month study period. Of these, 307 patients underwent completion or total thyroidectomy and were prescribed a 3-week, tapering course of calcium carbonate postoperatively. Twenty-four patients (7.8%) experienced symptoms of hypocalcemia which were managed easily with additional doses of oral calcium. A single patient (0.3%) required readmission. The cost of a 3-week regimen of calcium carbonate is approximately $15. This is considerably less expensive than the cost of overnight admission or published laboratory protocols that are designed to predict the risk of hypocalcemia. Conclusion: 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.