Association between preoperative neutrophil-to-lymphocyte ratio and transient hypocalcemia following total thyroidectomy

Mehmet Emin Gönüllü; Emin Sami Gürleyik; Fatih Gürsoy; Erman Yekenkurul; Mehmet Fuat Çetin

doi:10.38053/acmj.1949514

Association between preoperative neutrophil-to-lymphocyte ratio and transient hypocalcemia following total thyroidectomy

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.

Keywords

References

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Details

Primary Language

English

Subjects

General Surgery

Journal Section

Research Article

Authors

Mehmet Emin Gönüllü ^*
0000-0001-9126-2396
Türkiye

Emin Sami Gürleyik
0000-0001-8083-3835
Türkiye

Fatih Gürsoy
0000-0001-8299-494X
Türkiye

Erman Yekenkurul
0000-0002-6725-4289
Türkiye

Mehmet Fuat Çetin
0000-0002-9418-7288
Türkiye

Publication Date

September 11, 2026

Submission Date

May 12, 2026

Acceptance Date

July 18, 2026

Published in Issue

Year 2026 Volume: 8 Number: 5

DOI

https://doi.org/10.38053/acmj.1949514

IZ

https://izlik.org/JA99WB25JZ

Cite

RIS / Bibtex

APA

Gönüllü, M. E., Gürleyik, E. S., Gürsoy, F., Yekenkurul, E., & Çetin, M. F. (2026). Association between preoperative neutrophil-to-lymphocyte ratio and transient hypocalcemia following total thyroidectomy. Anatolian Current Medical Journal, 8(5), 846-852. https://doi.org/10.38053/acmj.1949514

AMA

1.Gönüllü ME, Gürleyik ES, Gürsoy F, Yekenkurul E, Çetin MF. Association between preoperative neutrophil-to-lymphocyte ratio and transient hypocalcemia following total thyroidectomy. Anatolian Curr Med J / ACMJ / acmj. 2026;8(5):846-852. doi:10.38053/acmj.1949514

Chicago

Gönüllü, Mehmet Emin, Emin Sami Gürleyik, Fatih Gürsoy, Erman Yekenkurul, and Mehmet Fuat Çetin. 2026. “Association Between Preoperative Neutrophil-to-Lymphocyte Ratio and Transient Hypocalcemia Following Total Thyroidectomy”. Anatolian Current Medical Journal 8 (5): 846-52. https://doi.org/10.38053/acmj.1949514.

EndNote

Gönüllü ME, Gürleyik ES, Gürsoy F, Yekenkurul E, Çetin MF (September 1, 2026) Association between preoperative neutrophil-to-lymphocyte ratio and transient hypocalcemia following total thyroidectomy. Anatolian Current Medical Journal 8 5 846–852.

IEEE

[1]M. E. Gönüllü, E. S. Gürleyik, F. Gürsoy, E. Yekenkurul, and M. F. Çetin, “Association between preoperative neutrophil-to-lymphocyte ratio and transient hypocalcemia following total thyroidectomy”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 5, pp. 846–852, Sept. 2026, doi: 10.38053/acmj.1949514.

ISNAD

Gönüllü, Mehmet Emin - Gürleyik, Emin Sami - Gürsoy, Fatih - Yekenkurul, Erman - Çetin, Mehmet Fuat. “Association Between Preoperative Neutrophil-to-Lymphocyte Ratio and Transient Hypocalcemia Following Total Thyroidectomy”. Anatolian Current Medical Journal 8/5 (September 1, 2026): 846-852. https://doi.org/10.38053/acmj.1949514.

JAMA

1.Gönüllü ME, Gürleyik ES, Gürsoy F, Yekenkurul E, Çetin MF. Association between preoperative neutrophil-to-lymphocyte ratio and transient hypocalcemia following total thyroidectomy. Anatolian Curr Med J / ACMJ / acmj. 2026;8:846–852.

MLA

Gönüllü, Mehmet Emin, et al. “Association Between Preoperative Neutrophil-to-Lymphocyte Ratio and Transient Hypocalcemia Following Total Thyroidectomy”. Anatolian Current Medical Journal, vol. 8, no. 5, Sept. 2026, pp. 846-52, doi:10.38053/acmj.1949514.

Vancouver

1.Mehmet Emin Gönüllü, Emin Sami Gürleyik, Fatih Gürsoy, Erman Yekenkurul, Mehmet Fuat Çetin. Association between preoperative neutrophil-to-lymphocyte ratio and transient hypocalcemia following total thyroidectomy. Anatolian Curr Med J / ACMJ / acmj. 2026 Sep. 1;8(5):846-52. doi:10.38053/acmj.1949514