Vasher et al reported a number of factors impacting the serum calcium following outpatient parathyroidectomy for primary hyperparathyroidism. Recognition of these factors can help to guide postoperative calcium replacement. The authors are from the Norman Parathyroid Center in Tampa, Florida.
Parameters:
(1) preoperative serum calcium concentration
(2) bone density
(3) body weight
(4) number of parathyroid glands removed
(5) number of remaining parathyroid glands manipulated during surgery
Parameter |
Finding |
Points |
preoperative serum calcium |
<= 12 mg/dL |
0 |
|
12.01 to 13.00 mg/dL |
1 |
|
13.01 to 13.50 mg/dL |
2 |
|
> 13.50 mg/dL |
3 |
bone density |
not severe osteoporosis |
0 |
|
severe osteoporosis (T score < -3) |
1 |
body weight |
not morbidly obese |
0 |
|
morbidly obese |
1 |
number of parathyroid glands removed |
1 |
0 |
|
2 or more |
1 |
number of the remaining parathyroid glands manipulated |
not all |
0 |
|
all |
1 |
total number of factors =
= SUM(points for all 5 parameters)
Interpretation:
• minimum number of factors: 0
• maximum number of factors: 7
• The greater the number of factors the greater the dose of replacement calcium required postoperatively.
• The authors estimated that each factor increased the replacement dose of calcium citrate required by 315 mg per day.
Specialty: Endocrinology, Clinical Laboratory, Surgery, orthopedic