瑞典初级甲状腺功能障碍症管理的区域差异:基于人口的病例对照研究
David Thorsteinsson1,2, Fredrik Granath3, Robert Bränström1,2
1Department of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden.
BJS open
|February 7, 2024
概括
对于一次性甲状腺功能障碍症的副甲状腺切除术的区域差异很大,可能是由于不同的手术转诊实践而不是社会经济因素. 这影响了患者获得基本治疗的机会.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 公共卫生 公共卫生
背景情况:
- 在用于原发性甲状腺功能障碍症的副甲状腺切除术中存在显著的差异.
- 这项研究调查了副甲状腺切除术发生率的区域差异.
研究的目的:
- 分析侧甲状腺切除术发生率的区域差异.
- 评估疾病负担和社会经济地位对这些变化的影响.
主要方法:
- 在瑞典 (2008-2017年) 进行了基于人口的病例控制研究.
- 包括8626名经过副甲状腺切除术的患者和匹配的对照.
- 利用国家登记处获取人口,社会经济,并发病和药物数据.
- 条件后勤回归分析了副甲状腺切除术的预测因素.
主要成果:
- 每年副甲状腺切除术的发病率因地区而异,在每10万人中从3.3到16.9之间.
- 社会经济地位的影响很小,低学历除外.
- 接受手术的患者有更多的症状,心血管/精神病药物,结石和骨质疏松症.
- 发病率较低的地区患有较高疾病负担的患者 (结石,骨质疏松症,高血压,较大的腺瘤,较高的).
结论:
- 观察到甲状腺副切除术率的区域差异很大.
- 变化更可能与临床检测和手术转诊值有关.
- 社会经济差异似乎不是这些差异的主要驱动因素.
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