{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:07:04Z","timestamp":1791612424512,"version":"4.3.4"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Hypoparathyroidism is the most common complication of total thyroidectomy for cancer, and requires calcium and\/or vitamin D supplementation for an unpredictable period of time. The additional cost associated with this complication has not hitherto been assessed. The aim of this study was to assess the economic burden of postoperative hypoparathyroidism after total thyroidectomy for cancer in France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on the French national cancer cohort, which extracts data from the French National Health Data System (SNDS), all adult patients who underwent a total thyroidectomy for cancer in France between 2011 and 2015 were identified, and their healthcare resource use during the first postoperative year was compared according to whether they were treated postoperatively with calcium and\/or vitamin D or not. Univariate and multivariate cost analyses were performed with the non-parametric Wilcoxon test and generalized linear model (gamma distribution and log link), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 31,175 patients analyzed (75% female, median age: 52y), 13,247 (42%) started calcium and\/or vitamin D supplementation within the first postoperative month, and 2,855 patients (9.1%) were still treated at 1 year. Over the first postoperative year, mean overall and specific health expenditures were significantly higher for treated patients than for untreated patients: \u20ac7,233 vs \u20ac6,934 per patient (p&amp;lt;0.0001) and \u20ac478.6 vs \u20ac332.7 per patient (p&amp;lt;0.0001), respectively. After adjusting for age, gender, Charlson Comorbidity index, ecological deprivation index, types of thyroid resection, lymph node dissection and complications, year and region, the incremental cost of overall health care utilization was \u20ac142 (p&amp;lt;0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study found a significant additional cost in respect of health expenditures for patients who had hypoparathyroidism after thyroidectomy for cancer, over the first postoperative year. Five-year follow-up is planned to assess the impact of more severe long-term complications on costs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2023.1193290","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T11:55:30Z","timestamp":1687953330000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Hypoparathyroidism-related health care utilization and expenditure during the first postoperative year after total thyroidectomy for cancer: a comprehensive national cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Fares","family":"Benmiloud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Le Bihan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanislas","family":"Rebaudet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Marino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe-Jean","family":"Bousquet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Bou\u00e9e-Benhamiche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1007\/s00423-008-0366-7","article-title":"Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3660 patients","volume":"393","author":"Bergenfelz","year":"2008","journal-title":"Langenbecks Arch Surg"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000701)89:1<202::AID-CNCR27>3.0.CO;2-A","article-title":"Initial results from a prospective cohort study of 5583 cases of thyroid carcinoma treated in the united states during 1996. U.S. and German thyroid cancer study group. an American college of surgeons commission on cancer patient care evaluation study","volume":"89","author":"Hundahl","year":"2000","journal-title":"Cancer"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2003.61","article-title":"The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients","volume":"133","author":"Thomusch","year":"2003","journal-title":"Surgery"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013589","article-title":"What is the care pathway of patients who undergo thyroid surgery in France and its potential pitfalls? a national cohort","volume":"7","author":"Mathonnet","year":"2017","journal-title":"BMJ Open"},{"key":"B5","unstructured":"The British association of endocrine and thyroid surgeons sixth national audit report2021"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2012.39.4.412","article-title":"A retrospective review of iatrogenic skin and soft tissue injuries","volume":"39","author":"Lee","year":"2012","journal-title":"Arch Plast Surg"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-3907","article-title":"Management of hypoparathyroidism: summary statement and guidelines","volume":"101","author":"Brandi","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2019.06.056","article-title":"Morbidity in patients with permanent hypoparathyroidism after total thyroidectomy","volume":"167","author":"Bergenfelz","year":"2020","journal-title":"Surgery"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1313e1318","DOI":"10.1002\/bjs.10843","article-title":"Mortality in patients with permanent hypoparathyroidism after total thyroidectomy","volume":"105","author":"Almquist","year":"2018","journal-title":"Br J Surg"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-1437-x","article-title":"To supplement or not to supplement: a cost-utility analysis of calcium and vitamin d repletion in patients after thyroidectomy","volume":"18","author":"Wang","year":"2011","journal-title":"Ann Surg Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ando.2021.07.085","article-title":"Hypoparathyroidism: consequences, economic impact, and perspectives. a case series and systematic review","volume":"82","author":"Fanget","year":"2021","journal-title":"Ann Endocrinol (Paris)"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2019.05.077","article-title":"A comparative cost-utility analysis of postoperative calcium supplementation strategies used in the current management of hypocalcemia","volume":"167","author":"Nicholson","year":"2020","journal-title":"Surgery"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25934","article-title":"Cost-effectiveness in transient hypocalcemia post-thyroidectomy","volume":"41","author":"Mercante","year":"2019","journal-title":"Head Neck"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2019.1624081","article-title":"Clinical burden and healthcare resource utilization among patients with chronic hypoparathyroidism, overall and by adequately vs. not adequately controlled disease: a multi-country chart review","volume":"22","author":"Chen","year":"2019","journal-title":"J Med Eco"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14128","article-title":"Burden of illness in not adequately controlled chronic hypoparathyroidism: findings from a 13-country patient and caregiver survey","volume":"92","author":"Siggelkow","year":"2020","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4233","article-title":"The national healthcare system claims databases in France, SNIIRAM and EGB: powerful tools for pharmacoepidemiology","volume":"26","author":"Bezin","year":"2017","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206448","article-title":"Cancer care and public health policy evaluations in France: usefulness of the national cancer cohort","volume":"13","author":"Bousquet","year":"2018","journal-title":"PloS One"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2022.05.006","article-title":"Monitoring breast cancer care quality at national and local level using the french national cancer cohort","volume":"22","author":"Houzard","year":"2022","journal-title":"Clin Breast Cancer"},{"key":"B19","doi-asserted-by":"publisher","first-page":"443","DOI":"10.2147\/CLEP.S198499","article-title":"Access to palliative care for cancer patients between diagnosis and death: a national cohort study","volume":"11","author":"Janah","year":"2019","journal-title":"Clin Epidemiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-020-05667-8","article-title":"Access to inpatient palliative care among cancer patients in France: an analysis based on the national cancer cohort","volume":"20","author":"Janah","year":"2020","journal-title":"BMC Health Serv Res"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.respe.2017.05.004","article-title":"Value of a national administrative database to guide public decisions: from the syst\u00e8me national d'information interr\u00e9gimes de l'Assurance maladie (SNIIRAM) to the syst\u00e8me national des donn\u00e9es de sant\u00e9 (SNDS) in France","volume":"65","author":"Tuppin","year":"2017","journal-title":"Rev Epidemiol Sante Publique"},{"key":"B22","unstructured":""},{"key":"B23","unstructured":""},{"key":"B24","unstructured":""},{"key":"B25","unstructured":""},{"key":"B26","unstructured":""},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med Care"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"Quan","year":"2011","journal-title":"Am J Epidemiol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000471","article-title":"The best use of the charlson comorbidity index with electronic health care database to predict mortality","volume":"54","author":"Bannay","year":"2016","journal-title":"Med Care"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-33","article-title":"\u201cEcological association between a deprivation index and mortality in France over the period 1997 - 2001: variations with spatial scale, degree of urbanicity, age, gender and cause of death","volume":"9","author":"Gr\u00e9goire","year":"2009","journal-title":"BMC Public Health"},{"key":"B32","unstructured":"Protocole national de diagnostic et de soins (PNDS) hypoparathyro\u00efdie"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-17-0589","article-title":"Time to parathyroid function recovery in patients with protracted hypoparathyroidism after total thyroidectomy","volume":"178","author":"Villarroya-Marquina","year":"2018","journal-title":"Eur J Endocrinol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2017.09.14","article-title":"Hypocalcaemia and permanent hypoparathyroidism after total\/bilateral thyroidectomy in the BAETS registry","volume":"6","author":"Chadwick","year":"2017","journal-title":"Gland Surg"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1530\/EC-21-0350","article-title":"Practice patterns for chronic hypoparathyroidism: data from patients and physicians in France","volume":"11","author":"Bertocchio","year":"2022","journal-title":"Endocr Connect"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2023.1193290\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T11:55:33Z","timestamp":1687953333000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2023.1193290\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,28]]},"references-count":35,"alternative-id":["10.3389\/fendo.2023.1193290"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2023.1193290","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,28]]},"article-number":"1193290"}}