{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:53:53Z","timestamp":1790787233043,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Decoding the immuno-inflammatory axis in rare non-medullary thyroid cancer as an innovative approach for novel combinatory therapeutic approaches","award":["81\/15.11.2022"],"award-info":[{"award-number":["81\/15.11.2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Thyroidectomy is a fundamental therapeutic intervention for various thyroid disorders, yet it entails significant risks, including iatrogenic hypoparathyroidism. Since 2019, our institution has implemented a standardized postthyroidectomy protocol using parathyroid hormone (PTH) and calcium measurements to stratify hypocalcemia risk and guide calcium and alfacalcidol supplementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to assess the effectiveness of this structured approach in reducing unscheduled referrals due to hypocalcemia within 3 weeks after total thyroidectomy and evaluate the utility of early postoperative PTH levels in predicting permanent hypoparathyroidism (PhP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational cohort study was conducted at Radboud University Medical Center Nijmegen, including 373 adult patients who underwent total\/completion thyroidectomy between January 2014 and April 2025. Patients were assigned to either the postprotocol implementation cohort (PPC) (N = 154) or the historic cohort (N = 219), depending on whether surgery occurred after or before protocol implementation, and subsequently compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Unscheduled referrals were significantly more frequent in the historic cohort than in the PPC (19.2% vs 11%, respectively, P\u202f=\u202f.034), and the introduction of the protocol was associated with a significant reduction in the odds of these referrals. Early postoperative PTH levels were a significant predictor of unscheduled referrals (P = .003), postoperative hypocalcemia (P &amp;lt; .001) and PhP (P &amp;lt; .001). A postoperative PTH cutoff of 1.7\u2005pmol\/L was identified as a clinically meaningful threshold for PhP prediction, demonstrating 100% sensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subject to assay availability and workflow efficiency, implementation of this protocol may reduce postthyroidectomy emergency consultations and readmissions, improving healthcare resource utilization and optimizing follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvag118","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:10:21Z","timestamp":1782875421000},"page":"68-76","source":"Crossref","is-referenced-by-count":1,"title":["Improving postthyroidectomy care using a parathyroid hormone and calcium-based algorithm"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8228-5473","authenticated-orcid":false,"given":"Ana","family":"Gheorghe-Milea","sequence":"first","affiliation":[{"name":"5th Department of Medical Sciences, Department of Endocrinology, Iuliu Ha\u021bieganu University of Medicine and Pharmacy , Cluj-Napoca ,","place":["Romania"]},{"name":"Department of Internal Medicine, Radboud University Medical Center , Nijmegen ,","place":["the Netherlands"]},{"name":"Department of Endocrinology, Cluj County Emergency Clinical Hospital , Cluj-Napoca ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes H W","family":"de Wilt","sequence":"additional","affiliation":[{"name":"Department of Oncological Surgery, Radboud University Medical Center , Nijmegen ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han J","family":"Bonenkamp","sequence":"additional","affiliation":[{"name":"Department of Oncological Surgery, Radboud University Medical Center , Nijmegen ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5417-8272","authenticated-orcid":false,"given":"Antonius E","family":"van Herwaarden","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Radboud University Medical Center , Nijmegen ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Emanuela","family":"Georgescu","sequence":"additional","affiliation":[{"name":"5th Department of Medical Sciences, Department of Endocrinology, Iuliu Ha\u021bieganu University of Medicine and Pharmacy , Cluj-Napoca ,","place":["Romania"]},{"name":"Department of Endocrinology, Cluj County Emergency Clinical Hospital , Cluj-Napoca ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romana","family":"Netea-Maier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Radboud University Medical Center , Nijmegen ,","place":["the Netherlands"]},{"name":"Research Center for Functional Genomics, Biomedicine and Translation Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy , Cluj-Napoca ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"issue":"6","key":"2026071304214793700_lvag118-B1","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1017\/S0022215120001024","article-title":"Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review","volume":"134","author":"McMurran","year":"2020","journal-title":"J Laryngol Otol"},{"issue":"Suppl 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