PACU XXXX facilitates safe outpatient total thyroidectomy.

@entity1 @entity3747 @entity261 @entity86 @entity460 @entity461 @entity560
OBJECTIVE: To determine if a serum @entity461 ( @entity461 )-based discharge algorithm can be used to safely facilitate outpatient total thyroidectomy. STUDY DESIGN: Case series with chart review of consecutive total and completion thyroidectomies performed by the senior author from March 2008 to November 2009. SETTING: An academic tertiary care center. SUBJECTS AND METHODS: At the authors' institution, @entity1 undergoing total or completion thyroidectomy are subject to a same-day discharge algorithm that incorporates postanesthesia care unit rapid @entity461 as the major discharge criterion. @entity1 with @entity461 >30 pg/mL are eligible for same-day discharge without supplementation, @entity1 with @entity461 between 20 and 30 pg/mL are eligible for discharge but receive @entity460 supplementation, and @entity1 with @entity461 <20 pg/mL are observed overnight (23 hours) with @entity460 and @entity560 supplementation. RESULTS: One hundred eighty @entity1 (mean age, 48.9 years; 83.3% female) underwent total (77.2%) or completion (22.7%) thyroidectomy with or without node dissection. Forty-two percent were performed with minimally invasive video-assisted (MIVA) technique. Seventy-six percent (137/180) of @entity1 had a @entity461 >20 pg/mL, meeting the @entity461 discharge criterion. Sixty-nine percent (95/137) of eligible @entity1 were discharged on the same day (53.1% of total). Ten percent of discharge-eligible @entity1 were admitted due to drain placement. Of the 95 @entity1 undergoing outpatient surgery, none were admitted, seen, or called for symptoms of @entity3747 in the postoperative period. All 180 @entity1 were eucalcemic at postoperative day (POD) 7 and POD 30 office visits. No @entity1 were @entity261 at POD 30. No significant difference in @entity86 existed between completion versus total thyroidectomy (11.1% vs 22.2%, P = .28) or MIVA versus standard technique (P = .37). CONCLUSION: A @entity461 -based discharge algorithm can safely facilitate outpatient total or completion thyroidectomy, with minimal risk of clinically significant outpatient @entity3747 .
