{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T23:16:31Z","timestamp":1775862991016,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Evaluate utility of postoperative phosphate and calcium\/phosphate ratio (Ca\/P) as surrogates for parathyroid hormone (PTH) following total thyroidectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed patients 18 years or older who underwent total thyroidectomy in a tertiary care hospital by a single surgeon from 2015 through 2021. Patients with incomplete data, pre\u2010existing hypoparathyroidism, vitamin D deficiency, or renal failure were excluded. All patients had PTH drawn within 4\u2009hours of surgery and serum calcium, albumin, and phosphate levels on postoperative Day 1. Corrected calcium was used to calculate a Ca\/P. Receiver operating characteristic (ROC) curves were generated to compare phosphate level or Ca\/P with PTH. Each possible surrogate was assessed relative to PTH cutoffs of less than 5, 10, 15, and 20\u2009pg\/mL. A good screening test was defined as having an area under the curve (AUC) greater than 0.8.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 185 patients underwent total thyroidectomy with 1 fellowship\u2010trained otolaryngologist. Most patients were female (62%), median age 48 years. Most surgeries were performed for cancer (68%). Six (3.2%) patients required IV calcium supplementation and 2 (1.1%) required readmission for symptomatic hypocalcemia. ROC curves comparing phosphate and Ca\/P to PTH at the listed cutoffs demonstrated AUC ranging from 0.55 to 0.66 and 0.61 to 0.79, respectively. None met the threshold for a good screening test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Postoperative phosphate and Ca\/P ratio are not surrogates for PTH levels following total thyroidectomy. More research is needed to identify cost\u2010effective strategies for postoperative calcium monitoring in patients undergoing total thyroidectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.703","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T07:34:44Z","timestamp":1710401684000},"page":"54-62","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing Postoperative Phosphate and Calcium\/Phosphate Ratio as Surrogates for Parathyroid Hormone Following Total Thyroidectomy"],"prefix":"10.1002","volume":"171","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7459-6298","authenticated-orcid":false,"given":"Catharine","family":"Kappauf","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Gold","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilo","family":"Gonzalez\u2010Velazquez","sequence":"additional","affiliation":[{"name":"Thyroid, Head and Neck Cancer (THANC) Foundation New York New York USA"},{"name":"Internal Medicine Department, Division of Endocrinology, Dr. Jose E. Gonz\u00e1lez Universidad Aut\u00f3noma de Nuevo Le\u00f3n San Nicol\u00e1s de los Garza  Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica H.","family":"Xing","sequence":"additional","affiliation":[{"name":"Thyroid, Head and Neck Cancer (THANC) Foundation New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quinn F.","family":"O'Malley","sequence":"additional","affiliation":[{"name":"Thyroid, Head and Neck Cancer (THANC) Foundation New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mykayla","family":"Sandler","sequence":"additional","affiliation":[{"name":"Thyroid, Head and Neck Cancer (THANC) Foundation New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond L.","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai New York New York USA"},{"name":"Thyroid, Head and Neck Cancer (THANC) Foundation New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2010.25.4.541"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9384"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03949.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2040-4603.2016.tb00690.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00424-018-2231-z"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00019616-199801000-00008"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.2435"},{"issue":"3","key":"e_1_2_8_9_1","first-page":"144","article-title":"Identification of patients at high risk for hypocalcemia after total thyroidectomy","volume":"31","author":"Tredici P","year":"2011","journal-title":"Acta Otorhinol"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-005-0057-2"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.1.63"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.06.053"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200404000-00017"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2310\/7070.2003.13985"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03949.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21199"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2012.08.030"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2017.03.03"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-31802010000500005"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820947009"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-020-02276-7"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181ec173d"},{"key":"e_1_2_8_23_1","unstructured":"National Health Expenditure Data. Centers for Medicare & Medicaid Services. Accessed January 4 2023.https:\/\/www.cms.gov\/research-statistics-data-and-systems\/statistics-trends-and-reports\/nationalhealthexpenddata\/nationalhealthaccountshistorical"},{"key":"e_1_2_8_24_1","unstructured":"Clinical Laboratory Fee Schedule. Centers for Medicare & Medicaid Services. Accessed January 4 2023.https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/ClinicalLabFeeSched\/Clinical-Laboratory-Fee-Schedule-Files"},{"issue":"1","key":"e_1_2_8_25_1","first-page":"91","article-title":"Central laboratory versus point of care testing in intraoperative monitoring of parathyroid hormone levels: cost comparison","volume":"37","author":"O'connell DA","year":"2008","journal-title":"J\u00a0Otolaryngol\u00a0Head Neck Surg"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-019-01025-6"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm4.10019"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2013.0049"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:36:32Z","timestamp":1760967392000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,14]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1002\/ohn.703"],"URL":"https:\/\/doi.org\/10.1002\/ohn.703","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,14]]},"assertion":[{"value":"2023-11-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}