Endocrine Abstracts

Background: Post-operative hypocalcaemia is a frequent complication following thyroid and parathyroid surgery. At Royal United Hospital, Bath, a “just in case” (JIC) calcium protocol was introduced. This provides patients with oral calcium supplements and information on hypocalcaemia symptoms upon discharge. This study evaluates the effectiveness of JIC calcium in reducing emergency department (ED) presentations and hospital admissions due to hypocalcaemia.

Method: A retrospective analysis was conducted on patients who underwent parathyroid (n = 51) and thyroid (n = 81) surgery between 2022 and 2024. Data were collected from electronic health records, focusing on pre- and post-operative calcium, PTH, and vitamin D levels, JIC calcium prescription, and hypocalcaemia related hospital attendances. The primary outcome was the rate of ED presentations before and after implementation of JIC calcium.

Results: The cost of JIC is £4.97. The average cost of an ED admission is £137 to £445 depending on investigations. Following the introduction of JIC, the number of admissions following parathyroid surgery was reduced by 50%. There was an 83% decrease in admissions for post thyroid surgery patients with the introduction for JIC. Most symptomatic patients had not received pre-operative calcium or vitamin D screening and many had bilateral procedures or vitamin D deficiency.

Conclusion: JIC calcium appears to be an effective, low-cost intervention for reducing hypocalcaemia related ED attendances. Its targeted use in high-risk patients, combined with improved perioperative screening, could further enhance post-surgical outcomes.