Screening and Management of postoperative Hypoparathyreoidism induced Hypocalcemia in thyreoidectomiced patients on endocrine compared to surgical wards

Background: Transient hypoparathyreoidism associated hypocalcemia is a common side-effect after thyreoidectomy. It can not only be life-threatening but can also distinctly affect length of hospital stay. However, screening and treatment was suspected to differ on endocrine vs. surgical wards.

Methods: Data from 170 patients who underwent thyroidal surgery and were admitted to the ENT- (n = 29), visceral surgery- (n = 49) and endocrine department (n = 92) were analyzed and compared for measurement of postoperative calcium and PTH, discharge with calciumlevels < 1,9 mmol/l, mode of treatment of hypocalcemia and duration of hospitalisation.

Results: Postoperative calcium level on endocrine wards was measured in 97.8% compared to 83.3% in the surgical departments (p-value = 0.002), postoperative PTH measurement and discharge with a calciumlevel > 1.9 mmol/l was statistically more frequent on endocrine vs. surgical wards. Additionally to calcium supplementation, on the endocrine ward activated vitamin D was administered in 95.5% vs. 33.3% on surgical wards. Length of hospitalization differed from 8.12 (± 6.2) days (endocrinology) to a mean stay of 10.55 (± 9.39) (surgical wards) (p = 0.057).

Conclusion: Screening and treatment of hypocalcemia differed immensely between endocrine and surgical wards. As monitoring of calcium levels is an important indicator for quality of postoperative care and helps to prevent complications we conclude that (with regard to the management of hypocalcemia) an interdisciplinary postoperative care on endocrine wards can be a successful future concept. It might even help to reduce length of hospital stay and therefore costs.