种族是否会影响副甲状腺切除术后的结果,以治疗二次和三次性副甲状腺功能障碍症?
Rebecca L Green1, Alexander M Fagenson1, Sunil S Karhadkar1
1Department of Surgery, Temple University Hospital, Philadelphia, PA, USA.
American journal of surgery
|July 15, 2023
概括
种族差异影响了副甲状腺切除术的结果. 患有二次性 (2HPT) 和三次性副甲状腺功能障碍症 (3HPT) 的非白人患者患病率较高,住院时间较长,这表明需要针对性干预.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 手术结果研究研究.
背景情况:
- 医疗保健中的种族差异对于具有可变治疗准则的疾病有充分证据.
- 这些差异对二次性 (2HPT) 和三次性 (4HPT) 甲状腺功能障碍症 (3HPT) 的手术结果的影响需要进一步研究.
研究的目的:
- 为了探索2HPT和3HPT的副甲状腺切除术后的结果的种族差异.
- 确定与手术结果差异相关的人口,并发症和疾病特异性因素.
主要方法:
- 对2015-2019年NSQIP数据集的分析.
- 为2HPT和3HPT进行副甲状腺切除术的患者的鉴定和单独分析.
- 按种族分层 (白人与非白人) 和结果的比较,包括30天的发病率,死亡率,重新手术,再入院和停留时间 (LOS).
主要成果:
- 对于2HPT (n=1,150),65.5%是非白人. 非白人患者患病率不成比例地高,重新手术率和长期LOS (>3天) 较高. 非白人种族是患病率的独立预测因素.
- 对于3HPT (n=262),53.1%的人不是白人. 非白人患者经历了不成比例地更长的LOS (>1天).
- 在2HPT和3HPT队列中,较高的性酸酶水平与长时间的LOS有关.
结论:
- 种族和晚期疾病的指标显著影响了2HPT和3HPT副甲状腺切除术后的结果.
- 解决种族差异和促进早期的患者转诊可能会改善外科手术的结果.
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