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Prolonged Hospital Stay After Parathyroidectomy for Secondary Hyperparathyroidism

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Abstract

Background

Protracted hypocalcemia is the most common complication after parathyroidectomy for secondary hyperparathyroidism. Several parameters have been identified to predict the degree of postoperative hypocalcemia. The purpose of this study was to determine whether there were any factors associated with prolonged hospitalization in these patients.

Methods

A total of 81 consecutive patients with end-stage renal disease and advanced secondary hyperparathyroidism who underwent parathyroidectomy between January 2004 and December 2006 were studied. The postoperative calcium infusion protocol and discharge criteria were standardized. Clinical variables were compared between patients with a shorter or longer postoperative stay.

Results

The mean postoperative hospital stay was 5.6 days. Preoperative alkaline phosphatase levels were significantly higher in patients with a longer stay (p = 0.035). In a linear regression model, the postoperative length of stay was moderately but significantly correlated with preoperative alkaline phosphatase levels (R 2 = 0.254; p < 0.001). Receiver operating characteristic analysis showed a significant area under the curve (0.678; 95% confidence interval 0.550–0.805; p = 0.014). With a cutoff of preoperative alkaline phosphatase levels at 200 IU/L, the sensitivity was 0.57 and the specificity was 0.59 for predicting a prolonged stay.

Conclusions

A high preoperative alkaline phosphatase level is significantly associated with prolonged hospital stay in patients undergoing parathyroidectomy for secondary hyperparathyroidism.

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Authors and Affiliations

  1. Department of Surgery, Mackay Memorial Hospital, 92, Sec 2, Chung-Shan North Road, Taipei, 10449, Taiwan

    Shih-Ping Cheng, Chien-Liang Liu, Jie-Jen Lee, Tsang-Pai Liu & Tsen-Long Yang

  2. Department and Institute of Pharmacology, National Yang-Ming University, 155, Sec 2, Linong Street, Taipei, 11221, Taiwan

    Shih-Ping Cheng

  3. Mackay Medicine, Nursing and Management College, 92, Sheng-Ching Road, Kwan-Tu, Peitou, Taipei, 11260, Taiwan

    Chien-Liang Liu, Han-Hsiang Chen, Tsang-Pai Liu & Tsen-Long Yang

  4. Department of Nephrology, Mackay Memorial Hospital, 92, Sec 2, Chung-Shan North Road, Taipei, 10449, Taiwan

    Han-Hsiang Chen

  5. Institute of Pharmacology, Taipei Medical University, 250, Wu-Xin Street, Taipei, 11031, Taiwan

    Jie-Jen Lee

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  1. Shih-Ping Cheng
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Correspondence to Tsen-Long Yang.

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Cheng, SP., Liu, CL., Chen, HH. et al. Prolonged Hospital Stay After Parathyroidectomy for Secondary Hyperparathyroidism. World J Surg 33, 72–79 (2009). https://doi.org/10.1007/s00268-008-9787-2

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