{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T22:40:23Z","timestamp":1784241623067,"version":"3.55.0"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Postoperative hypocalcemia caused by hypoparathyroidism and vocal cord paralysis\n                    remain common complications following thyroid surgery. Sex and metabolic\n                    comorbidities may influence their occurrence. We conducted a multicenter\n                    cross-sectional analysis using anonymized data from 3,365 patients (1,517\n                    hemithyroidectomies and 1,848 thyroidectomies) treated at 27 German hospitals\n                    between 2019 and 2024. Primary outcomes were postprocedural hypoparathyroidism\n                    and vocal cord paralysis, identified via ICD-10 codes. Associations with age,\n                    sex, obesity, diabetes, thyroid pathology, and surgical extent were analyzed\n                    using multivariable logistic regression. Postoperative hypoparathyroidism was\n                    more frequent after thyroidectomy (3.6%) than hemithyroidectomy (0.3%). Female\n                    sex was positively associated with postoperative hypoparathyroidism (odds ratio:\n                    2.30; 95% confidence interval: 1.11\u20134.77), while obesity was inversely\n                    associated with postoperative hypoparathyroidism (odds ratio: 0.15; 95%\n                    confidence interval: 0.04\u20130.63). Vocal cord paralysis was observed in 1.7% of\n                    hemithyroidectomy and 1.0% of thyroidectomy cases. Factors significantly or\n                    tendentially associated with vocal cord paralysis included malignant neoplasm\n                    (odds ratio: 4.00; 95% confidence interval: 1.37\u201311.64), diffuse goiter (odds\n                    ratio: 4.94; 95 % confidence interval: 0.86\u201328.37), parathyroidectomy (odds\n                    ratio: 3.47; 95% confidence: 1.04\u201311.59), and diabetes mellitus (odds ratio:\n                    3.09; 95% confidence: 0.98\u20139.74). Individual risk profiling and intraoperative\n                    neuromonitoring are critical to improving outcomes after thyroid surgery.<\/jats:p>","DOI":"10.1055\/a-2731-0631","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:02:02Z","timestamp":1765324922000},"page":"70-75","source":"Crossref","is-referenced-by-count":2,"title":["Factors Associated with Hypoparathyroidism and Vocal Cord Paralysis\n                    Following Thyroid Surgery: A Multicenter Cross-Sectional Analysis of 3,365\n                    Cases"],"prefix":"10.1055","volume":"58","author":[{"given":"Andreas","family":"Krieg","sequence":"first","affiliation":[{"name":"Department of General and Visceral Surgery, Thoracic Surgery and\n                    Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University\n                    Bochum, Herford, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel","family":"Kostev","sequence":"first","affiliation":[{"name":"Epidemiology, IQVIA, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Kirchner","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Thoracic Surgery and\n                    Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University\n                    Bochum, Herford, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Krieg","sequence":"additional","affiliation":[{"name":"University Clinic for People with Neurodevelopmental Disorders, Mara\n                    Hospital, Medical School and University Medical Center OWL, Bielefeld\n                    University, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schott","sequence":"additional","affiliation":[{"name":"Division for Specific Endocrinology, Heinrich-Heine-University and\n                    University Hospital Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"300060521996911","DOI":"10.1177\/0300060521996911","article-title":"Risk factors for postoperative hypocalcaemia after thyroidectomy: A systematic\n                    review and meta-analysis","volume":"49","author":"Z Chen","year":"2021","journal-title":"J Int Med Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"102420","DOI":"10.1016\/j.amjoto.2020.102420","article-title":"Risk factors and effects of hypocalcemia prior to discharge following\n                    thyroidectomy","volume":"41","author":"S J Torabi","year":"2020","journal-title":"Am J Otolaryngol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1177\/0194599812440401","article-title":"Risk factors for recurrent laryngeal nerve neuropraxia postthyroidectomy","volume":"146","author":"P Sheahan","year":"2012","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2280","DOI":"10.3390\/biomedicines10092280","article-title":"Analysis of risk factors for phonation disorders after thyroid surgery","volume":"10","author":"M G\u0142\u00f3d","year":"2022","journal-title":"Biomedicines"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/s0002-9610(98)00099-3","article-title":"Morbidity of thyroid surgery","volume":"176","author":"R Bergamaschi","year":"1998","journal-title":"Am J Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"4821","DOI":"10.1097\/js9.0000000000001471","article-title":"The risk factors for postoperative temporary vocal cord paralysis after thyroid\n                    cancer surgery: an observational retrospective cohort study","volume":"110","author":"Y Han","year":"2024","journal-title":"Int J Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1159\/000505496","article-title":"Thyroid carcinoma: do we need to treat men and women differently?","volume":"36","author":"K Lorenz","year":"2020","journal-title":"Visc Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1530\/joe-13-0029","article-title":"Oestrogen action on thyroid progenitor cells: relevant for the pathogenesis of\n                    thyroid nodules?","volume":"218","author":"S Xu","year":"2013","journal-title":"J Endocrinol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1007\/s00104-024-02140-8","article-title":"Gender medicine: endocrine and neuroendocrine diseases : Implications for\n                    surgery and perioperative management","volume":"95","author":"F Butz","year":"2024","journal-title":"Chirurgie (Heidelb)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"736972","DOI":"10.3389\/fendo.2021.736972","article-title":"The relationship and gender disparity between thyroid nodules and metabolic\n                    syndrome components based on a recent nationwide cross-sectional study and\n                    meta-analysis","volume":"12","author":"F Zhang","year":"2021","journal-title":"Front Endocrinol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1089\/thy.2007.0223","article-title":"Introducing the thyroid gland as another victim of the insulin resistance\n                    syndrome","volume":"18","author":"J Rezzonico","year":"2008","journal-title":"Thyroid"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.3390\/life13061292","article-title":"Thyroid nodules and obesity","volume":"13","author":"E Demetriou","year":"2023","journal-title":"Life (Basel)"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1158\/1055-9965.Epi-21-0255","article-title":"Association of metabolic health and central obesity with the risk of thyroid\n                    cancer: data from the korean genome and epidemiology study","volume":"31","author":"D N Nguyen","year":"2022","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"564","DOI":"10.21614\/chirurgia.114.5.564","article-title":"Post-thyroidectomy hypocalcemia \u2013 risk factors and management","volume":"114","author":"D N P\u0103duraru","year":"2019","journal-title":"Chirurgia 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Surg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"26","DOI":"10.3390\/cancers11010026","article-title":"Long-term outcome after hemithyroidectomy for papillary thyroid cancer: a\n                    comparative study and review of the literature","volume":"11","author":"Y Geron","year":"2018","journal-title":"Cancers (Basel)"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1159\/000510618","article-title":"Sex-specific differences in outcomes following thyroidectomy: a population-based\n                    cohort study","volume":"10","author":"L Gut","year":"2021","journal-title":"Eur Thyroid J"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1999","DOI":"10.1007\/s00423-021-02223-8","article-title":"The volume and outcome relationship for thyroidectomy in England","volume":"406","author":"W K Gray","year":"2021","journal-title":"Langenbecks Arch Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1186\/s12893-023-02176-3","article-title":"Incidental parathyroidectomy during total thyroidectomy and functional\n                    parathyroid preservation: a retrospective cohort study","volume":"23","author":"C Melot","year":"2023","journal-title":"BMC Surg"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e1014","DOI":"10.1097\/sla.0000000000003725","article-title":"Severe hypocalcemia after thyroidectomy: an analysis of 7366 patients","volume":"274","author":"H S Kazaure","year":"2021","journal-title":"Ann Surg"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"5047","DOI":"10.1097\/js9.0000000000001475","article-title":"Risk factors of transient and permanent hypoparathyroidism after thyroidectomy:\n                    a systematic review and meta-analysis","volume":"110","author":"K Ning","year":"2024","journal-title":"Int J Surg"},{"key":"ref24","first-page":"167","article-title":"Factors related to parathyroid weight in normal persons","volume":"107","author":"D R Dufour","year":"1983","journal-title":"Arch Pathol Lab Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1002\/path.1711280303","article-title":"The normal parathyroid gland at autopsy: the significance of stromal fat in\n                    adult patients","volume":"128","author":"A Dekker","year":"1979","journal-title":"J Pathol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2115","DOI":"10.1017\/s0007114522000149","article-title":"Sex differences in vitamin D metabolism, serum levels and action","volume":"128","author":"A Wierzbicka","year":"2022","journal-title":"Br J Nutr"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"18","DOI":"10.7812\/tpp\/18-188","article-title":"Hypocalcemia after Total Thyroidectomy in Graves Disease","volume":"23","author":"M Al 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Med"},{"key":"ref34","first-page":"1951","author":"J Llewelyn","year":"2005"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1212\/WNL.43.4.817","article-title":"The prevalence by staged severity of various types of diabetic neuropathy,\n                    retinopathy, and nephropathy in a population-based cohort: the Rochester\n                    Diabetic Neuropathy Study","volume":"43","author":"P J Dyck","year":"1993","journal-title":"Neurology"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.ijsu.2016.10.001","article-title":"Importance of latency and amplitude values of recurrent laryngeal nerve during\n                    thyroidectomy in diabetic patients","volume":"35","author":"I A Ozemir","year":"2016","journal-title":"Int J Surg"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1002\/lary.27359","article-title":"International neural monitoring study group guideline 2018 part I: Staging\n                    bilateral thyroid surgery with monitoring loss of signal","volume":"128 Suppl 3","author":"R Schneider","year":"2018","journal-title":"Laryngoscope"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2731-0631.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T01:30:13Z","timestamp":1772242213000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2731-0631"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":37,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,2,27]]},"published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2731-0631","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]}}}