Key result
Postoperative administration of calcitriol and calcium reduced hypocalcaemia compared to no treatment and was the most cost-effective strategy.
Why the study?
Does prophylactic administration of vitamin D or metabolites and calcium prevent hypocalcaemia and is it cost-effective in patients following total thyroidectomy?
Meta-Analysis
Does prophylactic administration of vitamin D or metabolites and calcium prevent hypocalcaemia and is it cost-effective in patients following total thyroidectomy?
Prophylactic treatment with vitamin D or metabolites plus calcium is a cost-effective strategy to prevent hypocalcaemia after total thyroidectomy.
Answers are grounded in this paper and cite their sources.
Supports routine post-thyroidectomy prophylaxis with calcitriol plus calcium; extends Level 1 evidence for cost-effective hypocalcaemia prevention.
OBJECTIVE: Hypocalcaemia is a frequently arising complication following total thyroidectomy. Routine postoperative prophylactic administration of vitamin D or metabolites and calcium reduce the incidence of symptomatic hypocalcaemia; this article reports evaluating its cost-effectiveness in Colombia. METHODS: Meta-analysis was used for comparing the administration of vitamin D or metabolites to oral calcium or no treatment at all in patients following total thyroidectomy and a cost-effectiveness analysis was designed based on a decision-tree model with local costs. RESULTS: The OR value for the comparison between calcitriol and calcium compared to no treatment and to exclusive calcium treatment groups was 0.32 (0.13-0.79 95 %CI) and 0.31 (0.14-0.70 95 %CI), respectively. The most cost-effective strategy was vitamin D or metabolites and calcium administration, having a US $0.05 incremental cost-effectiveness ratio. CONCLUSION: Prophylactic treatment of hypocalcaemia with vitamin D or metabolites + calcium or calcium alone is a cost-effective strategy.
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Sanabria et al. (2011) conducted a meta-analysis in Hypocalcaemia following total thyroidectomy. Vitamin D or metabolites (calcitriol) and calcium vs. Oral calcium alone or no treatment was evaluated on Symptomatic hypocalcaemia (OR 0.32, 95% CI 0.13-0.79). Postoperative administration of calcitriol and calcium reduced hypocalcaemia compared to no treatment and was the most cost-effective strategy.
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