Construction of a predictive model of intravenous calcium supplementation needs following total parathyroidectomy in patients with secondary hyperparathyroidism

Objective To develop a predictive model of intravenous calcium supplementation needs in patients with secondary hyperparathyroidism (SHPT) after total parathyroidectomy (t-PTX). Methods A retrospective analysis was conducted on data from 550 SHPT patients treated at the Department of Hepatobiliary Pancreatic Spleen Thyroid Surgery, General Hospital of Northern Theater Command, from January 2015 to December 2022. Various biochemical indices of the patients were evaluated, including sex, serum ferritin (SF), alkaline phosphatase (AKP), and free thyroxine (FT4). Statistical tests, such as t -tests, were performed to identify significant risk factors associated with the need for postoperative intravenous calcium supplementation. Results Sex ( t = −1.988, p = 0.049), SF ( t = 2.155, p = 0.033), AKP ( t = 4.501, p = 0.000), and FT4 ( t = −3.128, p = 0.002) were identified as risk factors associated with the need for postoperative intravenous calcium supplementation. The developed predictive model (intravenous calcium supplementation = 1235.561–158.547*gender + 0.141*SF + 0.442*AKP−494.055*FT4; male: 0, female: 1) was effective and passed the F test ( F = 22.034, p = 0.000). Conclusions The developed predictive model provides a reliable tool for estimating the amount of intravenous calcium supplementation needed by SHPT patients following t-PTX. By incorporating sex, SF, AKP, and FT4, clinicians can make informed decisions and tailor individualized calcium supplementation schemes. This evidence-based approach may contribute to improved patient outcomes and optimize postoperative care for SHPT patients undergoing t-PTX. Further validation and application of the model are warranted to enhance its clinical utility.