Population-level predictors of persistent hyperparathyroidism

摘要: Background Systematic study of outcomes initial surgery for primary hyperparathyroidism (PHPT) has been limited by selection and self-reporting biases. To avoid these biases, we evaluated parathyroidectomy (PTx) within an integrated health care system encompassing 3.25 million enrollees. Methods All patients undergoing PTx PHPT from 1995 to 2010 were studied. Persistent recurrent disease defined a serum calcium level >10.5 mg/dL before or after 6 months postoperatively, respectively. The effect demographic, clinical, hospital volume-related variables was assessed the use multivariate logistic regression. Results A total 1,190 operations performed at 14 hospitals. Follow-up levels available in 97% subjects. overall success rate 92%, 5% developed disease. Age ≥70 years predictive persistent (odds ratio 1.80, P 100 cases) predicted against 0.42, Conclusion is influenced patient age, volume, sestamibi scan result. Surgical may be optimized designating high-volume centers community setting.