Racial Disparities in Primary Hyperparathyroidism.
Black or African American
Aged
Female
Health Status Disparities
Healthcare Disparities
Humans
Hyperparathyroidism, Primary
/ complications
Male
Middle Aged
Parathyroid Hormone
/ blood
Parathyroidectomy
/ adverse effects
Preoperative Care
Retrospective Studies
Severity of Illness Index
United States
White People
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
accepted:
08
09
2020
pubmed:
27
9
2020
medline:
23
6
2021
entrez:
26
9
2020
Statut:
ppublish
Résumé
Racial disparities in surgery are increasingly recognized. We evaluated the impact of race on presentation, preoperative evaluation, and surgical outcomes for patients undergoing parathyroidectomy for primary hyperparathyroidism (PHPT). We performed a retrospective cohort study of patients undergoing parathyroidectomy for PHPT at a single center (1997-2015). Patients were classified by self-identified race, as African-American or White. The primary outcome was disease severity at referral. The secondary outcome was completeness of preoperative evaluation. Operative success and surgical cure were evaluated. A total of 2392 patients were included. The majority of patients (87.6%) were White. African-American patients had higher rates of comorbid disease as well as higher preoperative calcium (10.9 vs.10.8 mg/dl, p < 0.001) and PTH levels (122 vs. 97 pg/ml, p < 0.001). White patients were more likely to have history of bone loss documented by DXA and nephrolithiasis. African-American patients had lower rates of complete preoperative evaluation including DXA scan. Operatively, African-American patients had larger glands by size (1.7 vs. 1.5 cm, p < 0.001) and mass (573 vs. 364 mg, p < 0.001). We observed similar operative success (98.9 vs. 98.0%, p = 0.355) and cure rates (98.3 vs. 97.0%, p = 0.756). At the time of surgical referral, African-American patients with PHPT have more biochemically severe disease and higher rates of incomplete evaluation. Operative success and cure rates are comparable.
Sections du résumé
BACKGROUND
BACKGROUND
Racial disparities in surgery are increasingly recognized. We evaluated the impact of race on presentation, preoperative evaluation, and surgical outcomes for patients undergoing parathyroidectomy for primary hyperparathyroidism (PHPT).
METHODS
METHODS
We performed a retrospective cohort study of patients undergoing parathyroidectomy for PHPT at a single center (1997-2015). Patients were classified by self-identified race, as African-American or White. The primary outcome was disease severity at referral. The secondary outcome was completeness of preoperative evaluation. Operative success and surgical cure were evaluated.
RESULTS
RESULTS
A total of 2392 patients were included. The majority of patients (87.6%) were White. African-American patients had higher rates of comorbid disease as well as higher preoperative calcium (10.9 vs.10.8 mg/dl, p < 0.001) and PTH levels (122 vs. 97 pg/ml, p < 0.001). White patients were more likely to have history of bone loss documented by DXA and nephrolithiasis. African-American patients had lower rates of complete preoperative evaluation including DXA scan. Operatively, African-American patients had larger glands by size (1.7 vs. 1.5 cm, p < 0.001) and mass (573 vs. 364 mg, p < 0.001). We observed similar operative success (98.9 vs. 98.0%, p = 0.355) and cure rates (98.3 vs. 97.0%, p = 0.756).
CONCLUSIONS
CONCLUSIONS
At the time of surgical referral, African-American patients with PHPT have more biochemically severe disease and higher rates of incomplete evaluation. Operative success and cure rates are comparable.
Identifiants
pubmed: 32978665
doi: 10.1007/s00268-020-05791-w
pii: 10.1007/s00268-020-05791-w
pmc: PMC7906108
mid: NIHMS1632692
doi:
Substances chimiques
Parathyroid Hormone
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
180-187Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR001879
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2-TR001879
Pays : United States
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