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Dynamic nomogram for predicting hungry bone syndrome before parathyroidectomy

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Abstract

Purpose

The objective of this study was to develop a dependable and uncomplicated prediction model utilizing clinical information readily accessible to patients before surgery. This model aimed to assess the likelihood of hungry bone syndrome occurrence in post-surgery patients with secondary hyperparathyroidism (SHPT), and to assist clinicians in adjusting treatment plans promptly.

Methods

In this study, we constructed an online nomogram utilizing independent variables determined through multiple logistic regression to predict the probability of HBS occurrence after parathyroidectomy in patients with secondary hyperparathyroidism. To evaluate the precision and dependability of the nomogram, we used receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).

Results

Multivariate logistic regression analyses on 136 eligible patients identified age, parathyroid hormone (PTH), and blood calcium as independent HBS risk factors, which were then integrated into the nomogram. The area under ROC curve demonstrated the nomogram’s strong predictive accuracy. The calibration curve demonstrates consistency between the model’s prediction probability and observed probability, reflecting high prediction accuracy of the nomogram. Dynamic nomograms were found to hold significant practical clinical value as demonstrated by clinical decision analysis. It can be accessed on https://min115.shinyapps.io/dynnomapp/.

Conclusion

In patients with secondary hyperparathyroidism, the dynamic nomogram based on age, parathyroid hormone, and blood calcium can more accurately predict the likelihood of HBS after parathyroidectomy, allowing doctors to make clinical decisions more quickly and adjust treatment plans in a timely manner to reduce the incidence of HBS.

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Authors and Affiliations

  1. Jinzhou Medical University Postgraduate Training Base (Jinzhou Central Hospital), Jinzhou City, Liaoning Province, China

    Runmin Cao, Guangpeng Liang & Weibin Zhang

  2. Anhui University of Science and Technology, Huainan City, Anhui Province, China

    Honghe Jiang

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  1. Runmin Cao
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  2. Honghe Jiang
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  3. Guangpeng Liang
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  4. Weibin Zhang
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Contributions

R.C. prepared the original draft of the manuscript; R.C. and H.J. performed the statistical analysis; G.L. conducted a literature search. W.Z. reviewed and revised the article.

Corresponding author

Correspondence to Weibin Zhang.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki.The Ethics Committee of Jinzhou Central Hospital approved this retrospective study (No. JZ2023-0128).

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Cao, R., Jiang, H., Liang, G. et al. Dynamic nomogram for predicting hungry bone syndrome before parathyroidectomy. Endocrine 83, 196–204 (2024). https://doi.org/10.1007/s12020-023-03493-6

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  • DOI: https://doi.org/10.1007/s12020-023-03493-6

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