AI Summary & Key Takeaways
AI InsightHowever, its predictive role should be interpreted cautiously and validated in larger prospective studies.
📌 3 Key Takeaways
Abstract
Aims: The aim of this study was to investigate the association between preoperative neutrophil-to-lymphocyte ratio (NLR) and the development of transient hypocalcemia in patients undergoing total thyroidectomy. Methods: In this retrospective cohort study, 84 adult patients who underwent total thyroidectomy between January 2015 and December 2025 were evaluated. Patients were grouped according to the presence of transient hypocalcemia, defined as serum calcium <8.5 mg/dl on postoperative day 1. Demographic, clinical, operative, and laboratory variables were compared between groups. Logistic regression analyses were performed to identify factors associated with hypocalcemia, and receiver operating characteristic (ROC) analysis was used to assess the predictive performance of preoperative NLR. Results: Transient hypocalcemia developed in 42 patients (50.0%). Preoperative NLR was significantly higher in patients with hypocalcemia than in those without hypocalcemia (3.12±1.05 vs. 2.41±0.88, p=0.002), whereas age, gender, preoperative calcium, and preoperative parathyroid hormone levels were similar between groups. In multivariable logistic regression analysis, NLR remained independently associated with transient hypocalcemia [odds ratio: 1.72, 95% CI: 1.14-2.61, p=0.010]. ROC analysis showed moderate predictive performance for NLR, with an area under the curve of 0.76 (95% CI: 0.66-0.86, p<0.001). The optimal cut-off value was 2.75, with 73.8% sensitivity and 69.0% specificity. Conclusion: Preoperative NLR may be associated with the development of transient hypocalcemia following total thyroidectomy. As a simple, inexpensive, and routinely available inflammatory marker, NLR may provide additional information for preoperative risk assessment. However, its predictive role should be interpreted cautiously and validated in larger prospective studies.