Predicting risk factors of postoperative hypocalcemia after total thyroidectomy: is safe discharge without supplementation possible? A large cohort study.

PURPOSE: With increasing economic pressures to shorten the length of hospital stay, there has been much recent interest in studying risk factors for the development of postoperative hypocalcemia after total thyroidectomy. The aim of this study was to investigate whether serum calcium and/or PTH levels can predict post-thyroidectomy hypoparathyroidism. METHODS: From January to December 2014, 477 consecutive patients undergoing total thyroidectomy were included. Corrected calcemia and PTH were systematically performed on postoperative day 1/(POD1). Symptomatic patients were treated on POD1 or POD2 with calcium and vitamin D. RESULTS: Sixty-eight patients (14.25%) were treated for postoperative hypocalcemia. No patients with calcemia ≥ 2.16 mmol/l and PTH ≥ 1.9 pmol/l were supplemented and therefore were safely discharged on POD1 (specificity = 100%). All patients with calcemia ≤ 1.89 mmol/l were treated regardless the PTH values (n = 10) (specificity = 100%). For calcium value between 1.9 and 2.16 mmol/l with a PTH > 4.7 pmol/l, nobody was treated. With a calcemia between 1.9 and 2.16 mmol/l and a PTH > 1.9 pmol/l, 44 patients did not develop any symptom. ROC curve analysis showed that combination of Cac = 2.16 mmol/l and iPTH = 4.7 pmol/l provided a sensitivity of 97.06% and a specificity of 76.53% (p < 0.0001). We therefore propose an algorithm that would allow to 70% of patients could have been discharged on POD1 without risk of hypocalcemia or overtreatment. CONCLUSION: Combination of corrected calcemia and PTH on POD1 can efficiently predict hypocalcemia and be integrated into clinical practice for personalizing lengths of hospitalization and appropriate treatment. TRIAL REGISTRATION: ClinicalTrials.gov PRS. Unique Identifying number or registration ID: NCT04372225.

French validation of the FACE-Q Rhinoplasty module.

OBJECTIVES: The aim of this study was to translate the FACE-Q "Rhinoplasty" module into French and validate its use for the French-speaking population. DESIGN: "Satisfaction with the nose" and "Satisfaction with nostrils" questionnaires were used and translated. SETTINGS: We were granted permission to use the FACE-Q rhinoplasty module by the development team. These two questionnaires constitute the rhinoplasty module of the FACE-Q questionnaire. ISPOR and WHO recommendations were used to complete the translation process from English into French in six steps. MAIN OUTCOME MEASUREMENT: Our goal was to obtain, not a literal translation, but rather a translation of the idea or concept. RESULTS: Each step allowed us to make changes to achieve a conceptual translation equivalent to the original version. CONCLUSION: The FACE-Q questionnaire is a reference in the field of cosmetic surgery outcome evaluation. The use of two validated translation recommendations, with a six-step translation-back translation process, leads to a French version corresponding to the original. This version is usable in a French-speaking population.