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01-01-2021 | Hyperparathyroidism | Original Scientific Report

Racial Disparities in Primary Hyperparathyroidism

Authors: Jennifer Fieber, Kristin Goodsell, Rachel R. Kelz, Jae P. Ermer, Chris Wirtalla, Douglas L. Fraker, Heather Wachtel

Published in: World Journal of Surgery | Issue 1/2021

Abstract

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

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

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

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.

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Title: Racial Disparities in Primary Hyperparathyroidism
Authors: Jennifer Fieber
Kristin Goodsell
Rachel R. Kelz
Jae P. Ermer
Chris Wirtalla
Douglas L. Fraker
Heather Wachtel
Publication date: 01-01-2021
Publisher: Springer International Publishing
Keywords: Hyperparathyroidism
Parathyroidectomy
Parathyroidectomy
Urolithiasis
Published in: World Journal of Surgery / Issue 1/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05791-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Racial Disparities in Primary Hyperparathyroidism

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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