Aims
Parathyroidectomy (PT) is commonly performed for hyperparathyroidism. We investigated the association between surgical subspecialty and adverse outcomes in patients undergoing PT.
Materials and methods
This retrospective cohort analysis utilized the 2005–2018 National Surgery Quality Improvement Program (NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify cases with a primary procedure of PT. Demographics, comorbidities, and complication incidences were compared between patients undergoing surgery by general surgeons or otolaryngologists using chi-square analyses. The independent effect of surgical subspecialty on adverse outcomes was analyzed using binary logistic regression.
Results
49,667 (86.7%) PT performed by general surgeons and 7,595 (13.3%) by otolaryngologists were identified from 2005 to 2018. Chi-square analysis indicated that general surgery patients had lower incidences of obesity (42.0% vs. 44.6%; p < 0.001) and higher incidences of diabetes mellitus (8.1% vs. 5.8%; p < 0.001). Demographic characteristics that significantly differed between cohorts included race (p < 0.001) and age (p < 0.001). Unadjusted analyses indicated that otolaryngologist-performed PT had lower incidences of unplanned reoperation (0.9% vs. 1.1%; p = 0.048) and unplanned readmission (2.9% vs. 3.6%; p = 0.009). After adjusting for confounders, logistic regression analyses indicated that otolaryngologist-performed PT had increased odds of prolonged operation time (OR 1.605; 95% CI 1.475–1.746; p < 0.001). Significant differences in mortality, medical complications, and surgical complications were not found.
Conclusion
Surgical subspecialty is associated with PT operative time but is not associated with perioperative complications.
