The Ohio State University College of Medicine, Columbus, OH, USA.
Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA.
Int J Pediatr Otorhinolaryngol. 2024 Mar;178:111895. doi: 10.1016/j.ijporl.2024.111895. Epub 2024 Feb 12.
To investigate whether perioperative calcium and 1,25 OH vitamin D supplementation (PCDS) influences the rates of postoperative hypocalcemia and length of stay (LOS) following pediatric thyroidectomy.
Retrospective Cohort Review.
Tertiary children's hospital.
94 patients who underwent completion or total thyroidectomy with or without concomitant neck dissection from 2010 to 2020 at a single institution were included. Patients with pre-existing hypocalcemia or preoperative vitamin D insufficiency were excluded. Rates of postoperative hypocalcemia and LOS were compared for patients receiving PCDS to those receiving no supplementation.
Thirty percent of patients with PCDS had documented postoperative hypocalcemia compared to 64% of patients without PCDS (p = 0.01). Patients with PCDS had a median LOS of 30 h compared to 36 h (p = 0.002). Multivariable analyses confirmed that patients with PCDS had lower odds of postoperative hypocalcemia (OR: 0.32, CI: 0.11, 0.89) and shorter LOS by 17 h (SE: 8, p = 0.04) after adjustment for confounders.
PCDS is associated with significantly lower risk of hypocalcemia and shorter LOS. Standardizing preoperative care for pediatric patients undergoing thyroidectomy may decrease variability and improve outcomes following surgery.
研究围手术期钙和 1,25 羟维生素 D 补充（PCDS）是否会影响小儿甲状腺切除术后低钙血症的发生率和住院时间（LOS）。
回顾性队列研究。
三级儿童医院。
纳入了 2010 年至 2020 年期间在单家机构接受完成性或全甲状腺切除术（伴或不伴颈部清扫术）的 94 名患者。排除了术前存在低钙血症或维生素 D 不足的患者。比较了接受 PCDS 治疗的患者与未接受补充治疗的患者的术后低钙血症发生率和 LOS。
接受 PCDS 的患者中有 30%有术后低钙血症的记录，而未接受 PCDS 的患者中有 64%（p=0.01）。接受 PCDS 的患者 LOS 中位数为 30 小时，而未接受 PCDS 的患者为 36 小时（p=0.002）。多变量分析证实，在调整了混杂因素后，接受 PCDS 的患者术后低钙血症的可能性降低了 69%（OR：0.32，CI：0.11，0.89），LOS 缩短了 17 小时（SE：8，p=0.04）。
PCDS 与低钙血症风险显著降低和 LOS 缩短相关。为行甲状腺切除术的小儿患者标准化术前护理可能会减少手术前后的变异性并改善结果。
