BACKGROUND: The elderly are the fastest growing subset of the U.S. population, and suffer most from primary hyperparathyroidism. This is the first multi-institutional study to characterize 30-d outcomes in elderly patients undergoing parathyroidectomy. MATERIALS AND METHODS: Patients who underwent parathyroidectomy for primary hyperparathyroidism in ACS-NSQIP, 2005-8, were stratified into age groups: 45-64, 65-79, and ≥80 y. Independent patient variables included gender, race, inpatient/outpatient type, anesthesia, ASA classification, functional status, and presence/absence of >30 conditions. Outcomes included overall/system-specific complications, return to the OR, operating times, LOS, 30-d mortality. Patients 65-79 and ≥80 y were compared with younger ones using multivariable linear and logistic regression. RESULTS: A total of 7313 patients were identified: 77.8% women, 77.2% White, and 95.6% underwent first-time parathyroidectomy. Patients 65-79 and ≥ 80 y were more likely to have inpatient parathyroidectomies compared with younger patients (42.4%, 46.8% versus 36.0%) and higher ASA classification (42.4%, 59.8% versus 24.2%, all P < 0.01). Patients ≥ 80 y were less likely than those 45-64 y to receive general anesthesia (84.9% versus 89.8%, P < 0.01). Patients ≥ 65 y were more likely to have ≥1 complication (2.2% versus 1.3%, P < 0.01) and respiratory-specific complications compared with younger patients (0.9% versus 0.3%, P < 0.01). Patients 65-79 and ≥80 y were more likely to have extended hospital stays (7.7%, 12.2% versus 6.5%, P < 0.01); mortality rate for patients ≥ 80 y was higher (0.8% versus <0.1%, P < 0.01). On multivariable analysis, patients ≥ 65 y had increased risks for overall/respiratory complications and extended hospital stays, (all P < 0.01). CONCLUSIONS: Elderly patients sustain more morbidity following parathyroidectomy. Advanced age may be an independent risk factor worth considering in surgical decision-making.
BACKGROUND: The elderly are the fastest growing subset of the U.S. population, and suffer most from primary hyperparathyroidism. This is the first multi-institutional study to characterize 30-d outcomes in elderly patients undergoing parathyroidectomy. MATERIALS AND METHODS:Patients who underwent parathyroidectomy for primary hyperparathyroidism in ACS-NSQIP, 2005-8, were stratified into age groups: 45-64, 65-79, and ≥80 y. Independent patient variables included gender, race, inpatient/outpatient type, anesthesia, ASA classification, functional status, and presence/absence of >30 conditions. Outcomes included overall/system-specific complications, return to the OR, operating times, LOS, 30-d mortality. Patients 65-79 and ≥80 y were compared with younger ones using multivariable linear and logistic regression. RESULTS: A total of 7313 patients were identified: 77.8% women, 77.2% White, and 95.6% underwent first-time parathyroidectomy. Patients 65-79 and ≥ 80 y were more likely to have inpatient parathyroidectomies compared with younger patients (42.4%, 46.8% versus 36.0%) and higher ASA classification (42.4%, 59.8% versus 24.2%, all P < 0.01). Patients ≥ 80 y were less likely than those 45-64 y to receive general anesthesia (84.9% versus 89.8%, P < 0.01). Patients ≥ 65 y were more likely to have ≥1 complication (2.2% versus 1.3%, P < 0.01) and respiratory-specific complications compared with younger patients (0.9% versus 0.3%, P < 0.01). Patients 65-79 and ≥80 y were more likely to have extended hospital stays (7.7%, 12.2% versus 6.5%, P < 0.01); mortality rate for patients ≥ 80 y was higher (0.8% versus <0.1%, P < 0.01). On multivariable analysis, patients ≥ 65 y had increased risks for overall/respiratory complications and extended hospital stays, (all P < 0.01). CONCLUSIONS: Elderly patients sustain more morbidity following parathyroidectomy. Advanced age may be an independent risk factor worth considering in surgical decision-making.
Authors: Vera D Sabljak; Vladan R Zivaljevic; Biljana R Milicic; Ivan R Paunovic; Anka R Toskovic; Ksenija S Stevanovic; Katarina M Tausanovic; Dejan Z Markovic; Marina M Stojanovic; Mirko V Lakicevic; Milan D Jovanovic; Aleksandar D Diklic; Nevena K Kalezic Journal: Med Princ Pract Date: 2017-04-10 Impact factor: 1.927
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Authors: A A Khan; D A Hanley; R Rizzoli; J Bollerslev; J E M Young; L Rejnmark; R Thakker; P D'Amour; T Paul; S Van Uum; M Zakaria Shrayyef; D Goltzman; S Kaiser; N E Cusano; R Bouillon; L Mosekilde; A W Kung; S D Rao; S K Bhadada; B L Clarke; J Liu; Q Duh; E Michael Lewiecki; F Bandeira; R Eastell; C Marcocci; S J Silverberg; R Udelsman; K Shawn Davison; J T Potts; M L Brandi; J P Bilezikian Journal: Osteoporos Int Date: 2016-09-09 Impact factor: 4.507
Authors: Sun Moon Kim; Aimee D Shu; Jin Long; Maria E Montez-Rath; Mary B Leonard; Jeffrey A Norton; Glenn M Chertow Journal: PLoS One Date: 2016-08-16 Impact factor: 3.240