ABSTRACT
OBJECTIVES: Thyroid surgeries are among the most common operations performed in the world. Hypocalcemia following total thyroidectomy (TT) is a common complication that is sometimes difficult to correct. This study aims to determine the frequency of hypocalcemia and permanent hypoparathyroidism (PtHPT) following TT. METHODS: A total of 363 patient records were reviewed who underwent TT for any reason. Thirty-eight patients did not have a follow-up in the clinic in the postoperative period and were excluded from the final analysis with the final sample as 325. For patients who developed hypocalcemia during the postoperative hospital stay, their lowest calcium levels were recorded and medical records were reviewed for the period of one year for the requirement of oral calcium and active form of vitamin D (calcitriol or alpha calcidiol) in the outpatient setting. Patients who required calcium and vitamin D supplementation for up to 1 year were labeled as having PtHPT. Risk factors were analyzed among those who developed PtHPT. RESULTS: From a total of 325 patients postoperative hypocalcemia developed in 163 (50.2%) patients, and 162 (49.8%) patients remained normocalcemic. Permanent hypoparathyroidism was found in 42(12.9%) patients and transient HPT in 121 (37.2%). Age, severe postoperative hypocalcemia (PoHC), and readmission for hypocalcemia were independent risk factors for PtHPT. CONCLUSIONS: Transient hypoparathyroidism (THPT) is common in our setup. Patients who develop severe hypocalcemia postoperatively and need readmission should be closely followed for the development of PtHPT.
ABSTRACT
OBJECTIVE: To assess self-reported comfort of non-ear, nose and throat (ENT) health professionals in tracheostomy care and identify its associated factors. METHODS: This was a cross-sectional survey of non-ENT health care professionals, carried out from December 2011 to February 2013 at the Prince Sultan Military Medical City, and King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia. A self-administered questionnaire was used to collect data on self-rated comfort levels in performing tracheostomy tube change and factors, such as speciality, duration of dedicated ENT rotation in medical school, and years of experience as a practicing consultant. RESULTS: A total of 71 non-ENT health professionals participated in the survey. The response rate was 100%. Overall, one out of every 4 participants (26.8%) rated their comfort level in tracheostomy tube change as 'fair or poor', 38% as good, and only 35.2% as excellent. Comfort level was the highest among anesthesiologists (94.1%), and intensivists (78.9%). In the multivariate analysis, physicians who reported ever performing tracheostomy tube change as a resident were significantly more likely to report comfort than their counterparts without such exposure (adjusted odds ratio: 7.09; 95% confidence interval: 1.90-26.40; p=0.003). When asked if there should be a mandatory course on tracheostomy care in tertiary care hospitals, most of the participants (60-72%), irrespective of their speciality, training and experience, replied in the affirmative. CONCLUSION: Non-ENT health professionals involved in airway care had a low level of self-rated comfort with tracheostomy tube care suggesting the need for periodic refresher training to address this gap.
