Modeling the Relationship of Age With Hypocalcemia Following Total Thyroidectomy: A NSQIP Analysis
5 affiliations
- 1Northwestern University Feinberg School of Medicine Chicago Illinois USA
- 2Department of Otolaryngology‐Head and Neck Surgery Baylor College of Medicine Houston Texas USA
- 3Louisiana State University Health Sciences Center Department of Otolaryngology and Division of Pediatric Otolaryngology Children's Hospital of New Orleans New Orleans Louisiana USA
- 4Department of Otolaryngology‐Head and Neck Surgery University of Tennessee Health Science Center Memphis Tennessee USA
- 5Department of Otolaryngology‐Head and Neck Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA
Abstract
Objective To characterize the relationship between age and hypocalcemia risk following total thyroidectomy and identify critical age‐related transition points across the lifespan. Methods The American College of Surgeons National Surgical Quality Improvement Program Thyroidectomy Targeted database was queried for 21,109 adult patients (18+) from 2016 to 2023 who underwent total thyroidectomy. Multivariate regressions utilizing age, sex, race/ethnicity, BMI, surgical specialty, ASA classification, and surgical indication were used to assess odds of hypocalcemia within 30 days of surgery. Additionally, age‐stratified analyses, generalized additive modeling (GAM), and segmented regression were used to assess odds of hypocalcemia. Results Age was independently associated with 2% decreased odds of hypocalcemia per year older (OR, 0.98; 95% CI, 0.98–0.99; p‐value < 0.001). GAM and systematic evaluation of 1,683,217 segmented regression models identified six key inflection points at ages 26, 35, 39, 51, 54, and 71, with hypocalcemia risk characterized by sharp changes at these transition points and gradual changes between them. Inflection points in early adulthood were the most consistent across models, while those in older age showed greater variability, suggesting increasing physiological heterogeneity with advancing age. Risk stabilized after age 65 with no significant differences between consecutive age groups. Conclusion Hypocalcemia risk following total thyroidectomy follows a nonlinear age‐dependent pattern with identifiable transitions, challenging simple continuous or categorical age modeling. Risk stabilizes after the mid‐sixties, though very elderly patients should not be assumed to have lower risk due to advanced age alone. These findings support development of age‐tailored risk stratification tools for more personalized perioperative calcium management. Level of Evidence 4.
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BibTeX
@article{abrahamson2026modeling,
title = {{Modeling the Relationship of Age With Hypocalcemia Following Total Thyroidectomy: A NSQIP Analysis}},
author = {Cyrus W. Abrahamson and Daniel C. Chelius and Jill N. D'Souza and Amy L. Dimachkieh and Anthony M. Sheyn and Jeffrey C. Rastatter},
journal = {Laryngoscope Investigative Otolaryngology},
year = {2026},
month = oct,
doi = {10.1002/lio2.70566},
url = {https://doi.org/10.1002/lio2.70566},
note = {CC BY},
}
RIS
TY - JOUR
TI - Modeling the Relationship of Age With Hypocalcemia Following Total Thyroidectomy: A NSQIP Analysis
AU - Cyrus W. Abrahamson
AU - Daniel C. Chelius
AU - Jill N. D'Souza
AU - Amy L. Dimachkieh
AU - Anthony M. Sheyn
AU - Jeffrey C. Rastatter
PY - 2026
DA - 2026/10/28
JO - Laryngoscope Investigative Otolaryngology
DO - 10.1002/lio2.70566
UR - https://doi.org/10.1002/lio2.70566
AB - Objective To characterize the relationship between age and hypocalcemia risk following total thyroidectomy and identify critical age‐related transition points across the lifespan. Methods The American College of Surgeons National Surgical Quality Improvement Program Thyroidectomy Targeted database was queried for 21,109 adult patients (18+) from 2016 to 2023 who underwent total thyroidectomy. Multivariate regressions utilizing age, sex, race/ethnicity, BMI, surgical specialty, ASA classification, and surgical indication were used to assess odds of hypocalcemia within 30 days of surgery. Additionally, age‐stratified analyses, generalized additive modeling (GAM), and segmented regression were used to assess odds of hypocalcemia. Results Age was independently associated with 2% decreased odds of hypocalcemia per year older (OR, 0.98; 95% CI, 0.98–0.99; p‐value < 0.001). GAM and systematic evaluation of 1,683,217 segmented regression models identified six key inflection points at ages 26, 35, 39, 51, 54, and 71, with hypocalcemia risk characterized by sharp changes at these transition points and gradual changes between them. Inflection points in early adulthood were the most consistent across models, while those in older age showed greater variability, suggesting increasing physiological heterogeneity with advancing age. Risk stabilized after age 65 with no significant differences between consecutive age groups. Conclusion Hypocalcemia risk following total thyroidectomy follows a nonlinear age‐dependent pattern with identifiable transitions, challenging simple continuous or categorical age modeling. Risk stabilizes after the mid‐sixties, though very elderly patients should not be assumed to have lower risk due to advanced age alone. These findings support development of age‐tailored risk stratification tools for more personalized perioperative calcium management. Level of Evidence 4.
SN - 2378-8038
ER -