Early postoperative calcium-phosphate patterns as a predictor of prolonged calcium supplementation after total thyroidectomy
- Journal
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Q1)
- Published
- 31 August 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Ryota Iinuma, Hiroshi Okuda, Tomohiro Hasegawa, Ryokichi Ikeda, Takenori Ogawa
- PMID
- 42671598
- DOI
- 10.1007/s00405-026-10591-4
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (paper of the day, 1 September 2026): Early Ca‑P patterns predict prolonged calcium after total thyroidectomy
Abstract
PURPOSE: Postoperative hypocalcemia is a common complication after total thyroidectomy. While parathyroid hormone (PTH) is widely used for early prediction, its utility is limited by variable availability and accuracy. We explored the clinical utility of early postoperative calcium (Ca)-phosphate (P) patterns in predicting prolonged calcium supplementation. METHODS: The primary outcome was the duration of calcium supplementation after surgery. Calcium supplementation was considered prolonged when continuation exceeded 90 days, reflecting persistent impairment of calcium homeostasis. Supplementation was discontinued when serum calcium levels were maintained at ≥ 8.5 mg/dL on sequential measurements without supplementation. Patients who were still receiving supplementation at the end of the observation period were included, with duration calculated to the date of last follow-up. All patients who initiated calcium supplementation had documented follow-up beyond 90 days or were still receiving supplementation at the time of analysis; therefore, the primary outcome was reliably ascertained in all cases. RESULTS: Prolonged supplementation rates differed across groups: 42.3% in the low Ca-high P group, 30.0% in the intermediate group, and 7.1% in the high Ca-low P group. Duration also differed significantly (median: 52 vs. 24 vs. 2 days; p = 0.003). Multivariate analysis (n = 53 complete cases) revealed that the low Ca-high P pattern (odds ratio [OR] 4.22, 95% confidence interval [CI] 1.10-16.16; p = 0.036) and lateral neck dissection (OR 4.21, 95% CI 1.02-17.45; p = 0.048) were independently associated with prolonged supplementation. CONCLUSIONS: Early postoperative Ca-P patterns and lateral neck dissection may serve as practical indicators for predicting the risk of prolonged calcium supplementation after total thyroidectomy.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.