Restoring point-of-care testing during parathyroidectomy with a newer parathyroid hormone assay

David J Terris, Paul Maurice Weinberger, Tarik Farrag, Melanie Seybt, Joyce E. Oliver

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective. Intraoperative parathyroid hormone (IOPTH) monitoring has emerged as a useful adjunct in parathyroidectomy. Originally performed within the operating room, removal of the Nichols assay from the market forced many surgeons to rely on testing done in central laboratories, reducing convenience and prolonging operative times. The authors hypothesized that PTH assessment with a newer point-of-care (POC) assay would reduce results reporting time compared with central-laboratory PTH assays. Study Design. Cross-sectional study with planned data collection. Setting. Academic medical center. Subjects and Methods. Patients underwent parathyroidectomy for primary or recurrent hyperparathyroidism. Intraoperative monitoring of serum PTH levels was used to confirm biochemical cure following adenoma excision. Samples were run in duplicate using both a POC PTH assay (Future Diagnostics) located within the operating room and a laboratory-based assay (Turbo PTH). Samples were taken at incision and at 5-, 10-, and 15-minute intervals following removal of suspected parathyroid adenomas. Results reporting time was recorded and compared by nonparametric Wilcoxon rank sum test. Results. Sixty-six serum samples were assayed. There was excellent correlation between POC and central-laboratory IOPTH results (r = 0.880, P < .001). The POC IOPTH results were available faster than corresponding central-laboratory results, with a mean of 14.4 minutes compared with 30.7 minutes, respectively (P < .001). All patients (100%) demonstrated a biochemical cure by the end of the procedure. Conclusion. Use of a rapid POC IOPTH assay results in a significant decrease in the amount of time for laboratory results to be communicated to the surgical team. This reduces operative times for parathyroidectomy and improves patient care.

Original languageEnglish (US)
Pages (from-to)557-560
Number of pages4
JournalOtolaryngology - Head and Neck Surgery
Volume145
Issue number4
DOIs
StatePublished - Oct 1 2011

Fingerprint

Point-of-Care Systems
Parathyroidectomy
Parathyroid Hormone
Operating Rooms
Operative Time
Nonparametric Statistics
Intraoperative Monitoring
Parathyroid Neoplasms
Hyperparathyroidism
Serum
Adenoma
Point-of-Care Testing
Patient Care
Cross-Sectional Studies

Keywords

  • Minimally invasive parathyroidectomy
  • Parathyroid hormone assay
  • Parathyroidectomy
  • Point of care
  • Targeted parathyroid surgery

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Restoring point-of-care testing during parathyroidectomy with a newer parathyroid hormone assay. / Terris, David J; Weinberger, Paul Maurice; Farrag, Tarik; Seybt, Melanie; Oliver, Joyce E.

In: Otolaryngology - Head and Neck Surgery, Vol. 145, No. 4, 01.10.2011, p. 557-560.

Research output: Contribution to journalArticle

Terris, David J ; Weinberger, Paul Maurice ; Farrag, Tarik ; Seybt, Melanie ; Oliver, Joyce E. / Restoring point-of-care testing during parathyroidectomy with a newer parathyroid hormone assay. In: Otolaryngology - Head and Neck Surgery. 2011 ; Vol. 145, No. 4. pp. 557-560.
@article{27ced93f8667462591aeffbaaafe83be,
title = "Restoring point-of-care testing during parathyroidectomy with a newer parathyroid hormone assay",
abstract = "Objective. Intraoperative parathyroid hormone (IOPTH) monitoring has emerged as a useful adjunct in parathyroidectomy. Originally performed within the operating room, removal of the Nichols assay from the market forced many surgeons to rely on testing done in central laboratories, reducing convenience and prolonging operative times. The authors hypothesized that PTH assessment with a newer point-of-care (POC) assay would reduce results reporting time compared with central-laboratory PTH assays. Study Design. Cross-sectional study with planned data collection. Setting. Academic medical center. Subjects and Methods. Patients underwent parathyroidectomy for primary or recurrent hyperparathyroidism. Intraoperative monitoring of serum PTH levels was used to confirm biochemical cure following adenoma excision. Samples were run in duplicate using both a POC PTH assay (Future Diagnostics) located within the operating room and a laboratory-based assay (Turbo PTH). Samples were taken at incision and at 5-, 10-, and 15-minute intervals following removal of suspected parathyroid adenomas. Results reporting time was recorded and compared by nonparametric Wilcoxon rank sum test. Results. Sixty-six serum samples were assayed. There was excellent correlation between POC and central-laboratory IOPTH results (r = 0.880, P < .001). The POC IOPTH results were available faster than corresponding central-laboratory results, with a mean of 14.4 minutes compared with 30.7 minutes, respectively (P < .001). All patients (100{\%}) demonstrated a biochemical cure by the end of the procedure. Conclusion. Use of a rapid POC IOPTH assay results in a significant decrease in the amount of time for laboratory results to be communicated to the surgical team. This reduces operative times for parathyroidectomy and improves patient care.",
keywords = "Minimally invasive parathyroidectomy, Parathyroid hormone assay, Parathyroidectomy, Point of care, Targeted parathyroid surgery",
author = "Terris, {David J} and Weinberger, {Paul Maurice} and Tarik Farrag and Melanie Seybt and Oliver, {Joyce E.}",
year = "2011",
month = "10",
day = "1",
doi = "10.1177/0194599811413718",
language = "English (US)",
volume = "145",
pages = "557--560",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Restoring point-of-care testing during parathyroidectomy with a newer parathyroid hormone assay

AU - Terris, David J

AU - Weinberger, Paul Maurice

AU - Farrag, Tarik

AU - Seybt, Melanie

AU - Oliver, Joyce E.

PY - 2011/10/1

Y1 - 2011/10/1

N2 - Objective. Intraoperative parathyroid hormone (IOPTH) monitoring has emerged as a useful adjunct in parathyroidectomy. Originally performed within the operating room, removal of the Nichols assay from the market forced many surgeons to rely on testing done in central laboratories, reducing convenience and prolonging operative times. The authors hypothesized that PTH assessment with a newer point-of-care (POC) assay would reduce results reporting time compared with central-laboratory PTH assays. Study Design. Cross-sectional study with planned data collection. Setting. Academic medical center. Subjects and Methods. Patients underwent parathyroidectomy for primary or recurrent hyperparathyroidism. Intraoperative monitoring of serum PTH levels was used to confirm biochemical cure following adenoma excision. Samples were run in duplicate using both a POC PTH assay (Future Diagnostics) located within the operating room and a laboratory-based assay (Turbo PTH). Samples were taken at incision and at 5-, 10-, and 15-minute intervals following removal of suspected parathyroid adenomas. Results reporting time was recorded and compared by nonparametric Wilcoxon rank sum test. Results. Sixty-six serum samples were assayed. There was excellent correlation between POC and central-laboratory IOPTH results (r = 0.880, P < .001). The POC IOPTH results were available faster than corresponding central-laboratory results, with a mean of 14.4 minutes compared with 30.7 minutes, respectively (P < .001). All patients (100%) demonstrated a biochemical cure by the end of the procedure. Conclusion. Use of a rapid POC IOPTH assay results in a significant decrease in the amount of time for laboratory results to be communicated to the surgical team. This reduces operative times for parathyroidectomy and improves patient care.

AB - Objective. Intraoperative parathyroid hormone (IOPTH) monitoring has emerged as a useful adjunct in parathyroidectomy. Originally performed within the operating room, removal of the Nichols assay from the market forced many surgeons to rely on testing done in central laboratories, reducing convenience and prolonging operative times. The authors hypothesized that PTH assessment with a newer point-of-care (POC) assay would reduce results reporting time compared with central-laboratory PTH assays. Study Design. Cross-sectional study with planned data collection. Setting. Academic medical center. Subjects and Methods. Patients underwent parathyroidectomy for primary or recurrent hyperparathyroidism. Intraoperative monitoring of serum PTH levels was used to confirm biochemical cure following adenoma excision. Samples were run in duplicate using both a POC PTH assay (Future Diagnostics) located within the operating room and a laboratory-based assay (Turbo PTH). Samples were taken at incision and at 5-, 10-, and 15-minute intervals following removal of suspected parathyroid adenomas. Results reporting time was recorded and compared by nonparametric Wilcoxon rank sum test. Results. Sixty-six serum samples were assayed. There was excellent correlation between POC and central-laboratory IOPTH results (r = 0.880, P < .001). The POC IOPTH results were available faster than corresponding central-laboratory results, with a mean of 14.4 minutes compared with 30.7 minutes, respectively (P < .001). All patients (100%) demonstrated a biochemical cure by the end of the procedure. Conclusion. Use of a rapid POC IOPTH assay results in a significant decrease in the amount of time for laboratory results to be communicated to the surgical team. This reduces operative times for parathyroidectomy and improves patient care.

KW - Minimally invasive parathyroidectomy

KW - Parathyroid hormone assay

KW - Parathyroidectomy

KW - Point of care

KW - Targeted parathyroid surgery

UR - http://www.scopus.com/inward/record.url?scp=84856367624&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856367624&partnerID=8YFLogxK

U2 - 10.1177/0194599811413718

DO - 10.1177/0194599811413718

M3 - Article

VL - 145

SP - 557

EP - 560

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

SN - 0194-5998

IS - 4

ER -