ES17P IPTH FACILITATES DAY 1 DISCHARGE AFTER TOTAL THYROIDECTOMY: THE FIRST 50 CASES

Abstract

In recent years there has been much published about the use of iPTH to predict hypocalcemia with a view to achieving earlier safe discharge after total thyroidectomy. After recent publication of Australian data on this practice we developed a new protocol for post‐operative calcium management with the aim of achieving a greater number of patients being safely discharged on the first post‐operative day. We present our experience with the first 50 patients being treated under the new protocol.The first 50 patients admitted for total or completion thyroidectomy since May 2006 were studied and compared to 50 consecutive patients from 2002–2003, before the iPTH assay was used for thyroid surgery. iPTH was measured at 4‐hours post‐operatively and patients with iPTH in the normal range were discharged on the first post‐operative day. Statistical analysis was performed using the Mann‐Whitney U test.Fifty patients in each group were analyzed. Mean age in the study group was 56 years (51 years in the control group) and sex distribution were similar in both groups (M : F, 1 : 3). Mean lowest post‐operative corrected calcium levels in the study group were 2.19 mmol/L (2.15 mmol/L in the control group). Length of stay was significantly shorter in the study group, mean 1.71 days vs. 2.20 days (P < 0.05).The use of iPTH accurately predicts hypocalcemia after total thyroidectomy and can be used to facilitate safe early discharge for patients. This study demonstrates a significant reduction in the length of stay for patients undergoing total thyroidectomy when managed with a protocol based on a 4‐hour iPTH level.