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Hypocalcemia management strategies differ among physicians after thyroidectomy
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DENVER — Surgeons differ in strategies to prevent and manage post-thyroidectomy hypocalcemia, according to findings presented at the Annual Meeting of the American Thyroid Association.
J. Pieter Noordzij , MD, professor in the department of otolaryngology–head and neck surgery at Boston Medical Center, Boston University, and colleagues evaluated survey responses from 203 members of the ATA and 129 members of the International Association of Endocrine Surgeons to determine their practices for prevention and management of hypocalcemia after thyroidectomy.
Of those who responded, 72% had been in practice for 10 years, 45% were based outside of the United States, 34% were in private practice and 14% were trained in otolaryngology.
Preoperative serum 25-hydroxyvitamin D levels were tested before thyroidectomy by 26% of respondents. Prophylactic oral calcium supplementation was administered by 42% of respondents, and 13% reported administering prophylactic oral vitamin D supplementation for all patients immediately during the postoperative period.
Postoperative parathyroid hormone levels are routinely assessed to identify hypocalcemia by 53% of respondents; non-U.S. surgeons were more likely to use the levels (60%) compared with U.S.-based surgeons (48%; P = .02). Occasionally admitting thyroidectomy patients to trend calcium levels was reported by 29% of respondents, and routinely admitting them was reported by 16% — more often among otolaryngologists (3%) than among general surgeons (13%; P = .004).
“People should consider that variability exists in the perioperative management of hypocalcemia,” Noordzij told Endocrine Today. “Clinical guidelines should be developed to create a more unified approach to this common problem.” – by Amber Cox
Reference:
DePietro J, et al. Poster 123. Presented at: 86th Annual Meeting of the American Thyroid Association; Sept. 21-25, 2016; Denver.
Disclosure: Noordjiz reports no relevant financial disclosures.