Department of Otolaryngology, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, United States of America.
Department of Otolaryngology, Boston Medical Center, 830 Harrison Ave, 4(th) Floor, FGH Building, Boston, MA 02118, United States of America.
Am J Otolaryngol. 2020 May-Jun;41(3):102394. doi: 10.1016/j.amjoto.2020.102394. Epub 2020 Jan 25.
To determine international surgeon practice patterns for transient postoperative hypocalcemia in patients undergoing total thyroidectomy.
All member surgeons of the American Thyroid Association and the International Association of Thyroid Surgeons were contacted via email to complete a 20-question survey which included both questions about demographic information and preventing and managing postoperative hypocalcemia after thyroidectomy. Univariate analysis was performed to determine whether providers check preoperative vitamin D levels, postoperative calcium trends and/or PTH to assess for postoperative hypocalcemia.
A total of 332 surgeons responded to the survey with 72.26% in practice for >10 years and 82.18% performing >50 total thyroidectomies per year. 13.29% of surgeon's surveyed reported that they routinely check preoperative vitamin D levels. Surgeon case volume, type of practice (academic vs non-academic practice), and geographic location in the US were significant predictors of whether surgeons check preoperative Vitamin D levels. International surgeons were significantly more likely to check both postoperative serum Ca and PTH compared to US based surgeons (p < .01). There was no significance difference in practice patterns based on whether the surgeon was a General Surgeon or an Otolaryngologist.
Using a questionnaire distributed to both General Surgeons and Otolaryngologists, we demonstrated that there is significant variation in practice patterns between surgeons practicing in the United States and surgeons practicing in other countries, and practice often differs from recommended guidelines.
确定国际外科医生在接受甲状腺全切除术的患者中短暂性术后低钙血症的实践模式。
通过电子邮件联系所有美国甲状腺协会和国际甲状腺外科医生协会的成员外科医生，完成了 20 个问题的调查，其中包括有关人口统计学信息以及预防和管理甲状腺切除术后低钙血症的问题。进行单因素分析以确定提供者是否检查术前维生素 D 水平，术后钙趋势和/或 PTH 以评估术后低钙血症。
共有 332 名外科医生对该调查做出了回应，其中 72.26％的外科医生从业时间超过 10 年，82.18％的外科医生每年进行超过 50 例甲状腺全切除术。调查的 13.29％的外科医生报告说他们常规检查术前维生素 D 水平。外科医生的手术量，执业类型（学术与非学术实践）以及美国的地理位置是外科医生检查术前维生素 D 水平的重要预测指标。与美国的外科医生相比，国际外科医生更有可能检查术后血清 Ca 和 PTH（p <.01）。外科医生是普通外科医生还是耳鼻喉科医生，其手术模式没有明显差异。
通过向普通外科医生和耳鼻喉科医生分发问卷，我们证明了美国和其他国家的外科医生在手术模式上存在很大差异，并且实践通常与推荐的指南不同。
