澳大利亚甲状腺切除率的趋势和区域差异
Makaela A Bowman1, Steven J Craig1,2
1Department of Surgery, Shoalhaven District Memorial Hospital, Nowra, New South Wales, Australia.
ANZ journal of surgery
|October 17, 2025
概括
甲状腺手术趋势显示部分甲状腺切除术的增加和总甲状腺切除术的减少,可能受到新的指导方针的影响. 甲状腺手术中的地理差异仍然存在,尽管可能有所减少.
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:
- 甲状腺疾病的发病率在全球范围内有所上升,但死亡率仍保持稳定.
- 评估甲状腺手术趋势和澳大利亚的地理差异至关重要.
- 2015年美国甲状腺协会 (ATA) 准则的引入为实践变化提供了一个时间标记.
研究的目的:
- 分析2014-2023年澳大利亚甲状腺切除手术 (全切除,半切除,部分切除) 的趋势.
- 评估澳大利亚各州甲状腺切除率的地理差异.
- 调查2015年ATA指南对甲状腺手术实践的影响.
主要方法:
- 2014年1月至2023年12月期间使用的甲状腺切除项 (30296,30306,30310) 的医疗保险福利计划 (MBS) 数据.
- 针对全甲状腺切除和部分甲状腺切除子组的人均计算频率.
- 评估了手续费率的时间趋势和地理变化.
主要成果:
- 整体甲状腺手术没有显著的年增长 (2014 vs 2023).
- 部分甲状腺切除术显著增加 (p<0.01),而总甲状腺切除术显著减少 (p<0.01).
- 在各州 (高达300%的差异) 观察到人均甲状腺切除率的显著地理差异.
结论:
- 转向部分甲状腺切除术和减少全甲状腺切除术的转变可能反映了ATA指南的影响.
- 这些指导方针可能会减少医生驱动的地理差异,并降低低风险病例的升级程序.
- 多因素的影响,包括社会经济地位和获得医疗保健,有助于观察到的地理差异.
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