{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T04:34:47Z","timestamp":1783139687276,"version":"3.54.6"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T00:00:00Z","timestamp":1567209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Three different strategies to manage transient hypocalcemia after total thyroidectomy were compared to evaluate cost\u2010effectiveness. The reliability of total serum calcium (TSCa), ionized calcium (ICa), and intact parathyroid hormone (iPTH) were investigated to achieve this goal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter, prospective randomized study was carried out with 169 patients. The strategies were \u201cpreventive\u201d (oral calcium\u2009+\u2009vitamin D supplementation), \u201creactive\u201d (therapy in hypocalcemia), and \u201cpredictive\u201d (therapy if iPTH &lt;10 pg\/mL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TSCa had higher accuracy in identifying patients who developed hypocalcemia\u2010related symptoms than ICa (84.6% vs 50.0%). TSCa 24\u2009h after surgery showed 24.8% of patients with hypocalcemia, whereas TSCa 48\u2009h after surgery identified a further 10.6% with hypocalcemia (only in the \u201creactive\u201d and \u201cpredictive\u201d groups). iPTH showed low sensitivity as a predictor of hypocalcemia. Between the 3 groups, there was no significant difference in hospitalization time or number of symptomatic hypocalcemic patients. Interestingly, the cost\u2010per\u2010patient was significantly different among the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>None of the discussed strategies allowed for early discharge of patients without any risk of transient hypocalcemia. The \u201cpreventive\u201d strategy was the most cost\u2010effective, despite overtreatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.25934","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T13:28:18Z","timestamp":1567258098000},"page":"3940-3947","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Cost\u2010effectiveness in transient hypocalcemia post\u2010thyroidectomy"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1009-7892","authenticated-orcid":false,"given":"Giuseppe","family":"Mercante","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"},{"name":"Otorhinolaryngology Unit Humanitas Clinical and Research Center\u2014IRCCS  Milan 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