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Same-day parathyroidectomy for primary hyperparathyroidism -an over 20-year practice
Chandler A Annesi1, Andrea Gillis1, Jessica M Fazendin1
1Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
World Journal of Surgery
|August 22, 2024
Summary
Same-day parathyroidectomy is safe and increasingly common. Older Black patients and those on anticoagulants are more likely to require inpatient surgery, despite similar complication rates.
Area of Science:
- Endocrinology
- Surgical Oncology
- Health Services Research
Background:
- Same-day parathyroidectomy is gaining traction due to cost savings and comparable safety profiles.
- Previous research indicates minimal differences in postoperative outcomes between same-day and inpatient procedures.
Purpose of the Study:
- To investigate demographic, risk factor, and comorbidity associations with same-day versus inpatient parathyroidectomy.
- To analyze trends in parathyroidectomy practice patterns over two decades.
Main Methods:
- A prospective database of 2948 primary hyperparathyroidism surgeries from 2001-2022 was analyzed.
- Patients were classified into same-day or inpatient cohorts.
- Demographic, risk factor, and comorbidity data were examined, with trend analysis over time.
Main Results:
- In 2013-2022, inpatient surgery patients were more likely to be Black and use anticoagulation/antiplatelet therapy.
- Multivariable analysis confirmed older age and Black race increased odds of inpatient parathyroidectomy.
- The proportion of same-day surgeries significantly increased from 2001-2003 to 2019-2022.
Conclusions:
- Same-day parathyroidectomy is a safe and established practice for high-volume surgeons.
- Demographic factors, particularly age and race, influence the likelihood of requiring inpatient parathyroidectomy.
- While same-day surgery is prevalent, specific patient demographics necessitate consideration for inpatient care.
