SFEBES2023 Poster Presentations Bone and Calcium (41 abstracts)
UHCW, Coventry, United Kingdom
As per NICE guideline, referral for parathyroidectomy need to be according the below, symptoms of hypercalcaemia or End-organ disease (renal stones, fragility fractures or osteoporosis) or An albumin-adjusted serum calcium level of 2.85 mmol/litre or above.
Methods: We conducted a retrospective analysis of investigations done as per recommendation of NICE guidelines for patients who underwent Parathyroidectomy under the care of 2 parathyroid surgeons at UHCW between 2017 to 2022. Data was collected from the hospital database. Data analysed using Microsoft excel.
Results: 13 patients had recurrence following the parathyroidectomy (some of these patients were refereed from different hospitals).
| Demographics: | Gender | number, % | |
| Female | n= 126, 72% | ||
| male | n= 48, 28% | ||
| Biochemical analysis: | |||
| Calcium (mmol/l) | >=2.5 | <2.5 | not done |
| n=163, 93% | n=10, 5% | n=2, 1% | |
| PTH ( pmol/l) | >=6.9 | <6.9 | not done |
| n=144, 82% | n=2.9, 16% | n=2, 1% | |
| Vitamin D (nmol/l) | >50 | <50 | not done |
| n=94, 53% | n=58, 33% | n=14, 8% | |
| Phosphate (mmol/l) | done | not done | |
| n=94, 53% | n= 81, 46% | ||
| Random urine calcium:creatinine clearance ratio | done | not done | |
| n=77, 44% | n=98, 56% | ||
| 24h urine calcium | done | not done | |
| n= 76, 43% | n=99, 56% | ||
| Imaging: | |||
| Ultrasound parathyroid | done | not done | |
| n= 159, 90% | n= 16, 10% | ||
| MIBI | done | not done | |
| n=151, 86% | n=24, 24% | ||
| 4D CT | done | not done | |
| n=29, 16% | n=149, 83% | ||
| Renal tract USS | done | not done | |
| n=89, 50% | n=86, 49.9% | ||
| DEXA | DONE | not done | |
| n=137,78% | n=38, 21% | ||
| normal n=29, | |||
| abnormal n= 108 |
Discussion: In this retrospective audit more than half of the cohort had not been screened for urine calcium excretion to exclude familial hypocalciuric hypercalcemia and 50% didnt had ultrasound of the renal tract. Although 98.3% patients had confirmed histology, all investigations should be performed as per NICE guidelines before undergoing a parathyroidectomy.