Modification, validation and implementation of a protocol for post-thyroidectomy hypocalcaemia

Area of Science:

• Endocrinology
• Surgical Management
• Patient Outcomes

Background:

• Post-thyroidectomy hypocalcaemia poses risks of readmission and overtreatment.
• Optimal management protocols are crucial for patient safety and efficient healthcare delivery.

Purpose of the Study:

• To implement, evaluate, and revise a protocol for managing post-thyroidectomy hypocalcaemia.
• To reduce hypocalcaemia, readmissions, and treatment-related hypercalcaemia.
• To facilitate early patient discharge after thyroid surgery.

Main Methods:

• Introduction of Day 1 parathyroid hormone (PTH) and calcium measurements.
• Review of a three-year patient cohort to amend the protocol.
• Validation of revised protocols over seven months, assessing compliance and outcomes.
• Implementation of further revisions based on collected data.

Main Results:

• Temporary and long-term hypocalcaemia rates were 29.1% and 3.2%, respectively.
• Day 1 calcium measurements altered management in only 1.4% of cases.
• Protocol adherence reached 90%, with minimal post-discharge hyper/hypocalcaemia episodes.

Conclusions:

• A unit protocol for post-thyroidectomy hypocalcaemia, refined by literature and local data, is effective.
• Day 1 PTH and calcium levels guide treatment, follow-up, and early discharge.
• The protocol minimizes risks of undertreatment and overtreatment, indicating permanent hypocalcaemia accurately.