The following is a summary of “Does race impact outcomes after parathyroidectomy for secondary and tertiary hyperparathyroidism?,” published in the NOVEMBER 2023 issue of Surgery by Green, et al.
Disparities in healthcare have been observed across various diseases, especially those with diverse treatment guidelines. For a study, researchers sought to delve into understanding racial disparities in outcomes post-parathyroidectomy for secondary (2HPT) and tertiary hyperparathyroidism (3HPT).
Utilizing the 2015–2019 NSQIP datasets, patients who underwent parathyroidectomy specifically for 2HPT and 3HPT were isolated and analyzed based on their racial background (white versus non-white). Various parameters were assessed, such as demographics, underlying health conditions, and post-operative outcomes. The outcomes under scrutiny encompassed 30-day morbidity, mortality rates, unplanned reoperations, readmissions, and postoperative length of stay (LOS).
Out of the total, 1,150 patients were diagnosed with 2HPT, with 65.5% being non-white. Notably, non-white patients displayed a higher frequency of post-operative complications like morbidity, unplanned reoperations, and extended LOS (>3 days). Furthermore, the non-white racial category was independently linked with increased morbidity. Elevated ASA class and alkaline phosphatase levels emerged as significant predictors of prolonged LOS. For the 3HPT cohort, comprising 262 patients, with 53.1% being non-white, the data indicated that non-white patients more frequently experienced an extended LOS (>1 day). Moreover, heightened alkaline phosphatase levels were an independent predictor of extended LOS.
The research underscored that both race and indicators of advanced disease stages play pivotal roles in determining post-operative outcomes following parathyroidectomy for 2HPT and 3HPT. Recognizing and addressing these racial disparities, coupled with timely referrals, can potentially ameliorate these outcomes.
Source: americanjournalofsurgery.com/article/S0002-9610(23)00325-2/fulltext