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World Journal of Surgery

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01-02-2020 | Hyperparathyroidism | Original Scientific Report

Effects of Social Disparities on Management and Surgical Outcomes for Patients with Secondary Hyperparathyroidism

Authors: Brittany Greene, S. Joseph Kim, Ellen P. McCarthy, Jesse D. Pasternak

Published in: World Journal of Surgery | Issue 2/2020

Abstract

Introduction

Nearly 80% of chronic renal failure patients have secondary hyperparathyroidism. Cinacalcet is used to lower parathyroid hormone; however, it is expensive and has side effects. When secondary hyperparathyroidism is resistant to medication or medications are inaccessible, parathyroidectomy is performed. Race and socioeconomic status influence access to care and surgical outcomes. We sought to evaluate the effect of race and socioeconomic status on parathyroidectomy rate as well as surgical outcomes of patients with secondary hyperparathyroidism.

Methods

We undertook cross-sectional analysis of adults diagnosed with secondary hyperparathyroidism in the USA between 2012 and 2014, using the National Inpatient Sample. Univariate and multivariate analyses were used to determine associations between social disparities, likelihood to undergo parathyroidectomy, and surgical outcomes.

Results

Between 2012 and 2014, a national estimate of 724,170 hospitalizations were identified where patients had a diagnosis of secondary hyperparathyroidism. Operative rate was 0.67%. By socioeconomic status, differences in rates of surgery in the poorest compared to the richest were not significant (0.74% vs. 0.55%, OR 1.08, p = 0.5). African-American patients had higher rates of parathyroidectomy compared to Caucasians (1 vs. 0.74%, OR 1.49, p < 0.001). African-American patients also had a trend toward more complications and greater length of stay.

Conclusions

According to a large administrative dataset, parathyroidectomy for secondary hyperparathyroidism is seldom used in the USA. African-American patients have higher rates of surgical management. Surgical outcomes may be affected by race. Clinicians treating secondary hyperparathyroidism should be aware of existing disparities within their health system.

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Title: Effects of Social Disparities on Management and Surgical Outcomes for Patients with Secondary Hyperparathyroidism
Authors: Brittany Greene
S. Joseph Kim
Ellen P. McCarthy
Jesse D. Pasternak
Publication date: 01-02-2020
Publisher: Springer International Publishing
Keywords: Hyperparathyroidism
Parathyroidectomy
Parathyroidectomy
Cinacalcet
Published in: World Journal of Surgery / Issue 2/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05207-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effects of Social Disparities on Management and Surgical Outcomes for Patients with Secondary Hyperparathyroidism

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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