Racial Disparities in Primary Hyperparathyroidism.
Racial Disparities in Primary Hyperparathyroidism.
复制标题
DOI：
10.1007/s00268-020-05791-w
复制
发表时间：
2021-01
影响因子：
2.6
通讯作者：
Wachtel H
中科院分区：
文献类型：
--
作者：
Fieber J;Goodsell K;Kelz RR;Ermer JP;Wirtalla C;Fraker DL;Wachtel H
外科手术中的种族差异越来越被认识到。我们评估了种族对接受甲状旁腺切除术的原发性甲状旁腺功能亢进症(PHPT)患者的临床表现、术前评估和手术结果的影响。我们对在一个中心接受甲状旁腺切除术的患者进行了一项回顾性队列研究(1997-2015)。患者根据自我认同的种族进行分类，即非裔美国人或白人。主要结果是转诊时的疾病严重程度。次要结果是术前评估的完整性。评价手术成功率和手术治愈率。总共有2392名患者被纳入研究。大多数患者(87.6%)是白人。非裔美国人患者的合并症发生率更高，术前钙(10.9vs.10.8 mg/dl，p<；0.001)和甲状旁腺素水平(122vs.97pg/ml，p<；0.001)也较高。白人患者更有可能有DXA记录的骨丢失和肾结石病史。非裔美国人患者的完整术前评估率较低，包括DXA扫描。手术中，非裔美国患者的腺体更大(1.7vs.1.5厘米，p<；0.001)和质量(573vs.364 mg，p<；0.001)。我们观察到相似的手术成功率(98.9比98.0%，p=0.355)和治愈率(98.3比97.0%，p=0.756)。在手术转诊时，患有PHPT的非裔美国人有更严重的生化疾病和更高的不完全评估率。手术成功率和治愈率具有可比性。
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 2,392 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.
登录
查看更多内容
影响因子：
3.1
作者：
Halpern, Michael T.;Pavluck, Alexandre L.;Ward, Elizabeth M.
通讯作者：
Ward, Elizabeth M.
影响因子：
16.9
作者：
Wilhelm, Scott M.;Wang, Tracy S.;Carty, Sally E.
通讯作者：
Carty, Sally E.
影响因子：
5.8
作者：
Yeh, Michael W.;Ituarte, Philip H. G.;Adams, Annette L.
通讯作者：
Adams, Annette L.
影响因子：
9
作者：
Sosa, Julie Ann;Mehta, Pritesh J.;Roman, Sanziana A.
通讯作者：
Roman, Sanziana A.
影响因子：
3.8
作者：
Naples, Robert;Shin, Joyce J.;Siperstein, Allan E.
通讯作者：
Siperstein, Allan E.