Predicting calcium status post thyroidectomy with early calcium levels

OBJECTIVE. The study goals were to predict postoperative normocalcemia and hypocalcemia after total thyroidectomy using calcium levels and to assess the value of a standardized protocol in managing the total thyroidectomy patient. STUDY DESIGN: We conducted a prospective study encompassing 68 patients undergoing a total thyroidectomy using a standardized protocol. Blood to measure postoperative calcium levels was drawn at 6, 12, and 20 hours and then twice daily thereafter. Calcium slope was calculated from the 6- and 12-hour serum corrected calcium levels. RESULTS: Logistic regression analysis allowed the comparison of the 6- and 12-hour calcium slope versus proportion of normocalcemic patients post-operatively. A slope of +0.02 had a 97% chance of remaining normocalcemic (p = 0.0007). CONCLUSION. Successful prediction of calcium status post total thyroidectomy can be achieved using the slope of the 6- and 12-hour calcium levels. The risk of developing severe hypocalcemia can also be predicted with these slope values. Implementation of the protocol resulted in a significant reduction in the duration of. hospital stay for patients who remain normocalcemic.