Epidemiology and management of parathyroid gland disorders in Spain over 15 years: A retrospective multicentre analysis

Abstract

Parathyroid gland disorders are rare conditions with an incidence that displays great variability among populations. Its direct influence in calcium homeostasis originates variable symptoms that affect bone remodelling among other processes. This study aimed to provide data on the epidemiology and characteristics of patients admitted with these disorders in Spain between 2003 and 2017, and to analyse disease management and direct medical costs. Medical records in which a disorder of the parathyroid gland was registered as the admission motive were extracted from a nationwide hospital-discharge database via the Spanish Ministry of Health. Records from 12,903 patients were obtained, with predominance of female patients (74.70%) and of admissions due to hyperparathyroidism (90.23%). The number of patients admitted per year increased over the study period along the incidence of these disorders. The year 2017 incidence of hyperparathyroidism was 2.95 per 10,000, 4.03 per 10,000 in females and 1.37 in males; the same year, the incidence of hypoparathyroidism was 0.17 per 10,000. Length of hospital stay was significantly extended in patients with hypoparathyroidism (7.16 days), admitted mostly due to emergencies. Heart failure was diagnosed in more than 20% of admissions in patients with secondary and tertiary hyperparathyroidism and hypoparathyroidism, while this last group displayed the highest levels of mineral metabolism disruption. Parathyroidectomy was performed in 78.95% of all admissions for primary hyperparathyroidism. The total annual direct medical cost parathyroid gland disorders has increased over the study period, due to the increase of the costs associated to hyperparathyroidism, whereas the cost per patient remained relatively stable, with an average of €3,748, €3,430 and €3,737 for patients with hyperparathyroidism, hypoparathyroidism and other disorders of the parathyroid gland, respectively. This study provides novel data to extend the scarce available knowledge on parathyroid gland disorders' epidemiology and management in Spain.

Recent Trends in Hypoparathyroidism-Related Inpatient and Emergency Department Admissions and Costs in the United States

“…The mean LOS for HypoPT-related inpatient hospitalizations in our study was between 6.5 and 7.2 days and was consistently longer across all years than those reported for non-HypoPT-related stays. Our data are consistent with findings from a retrospective study in Spain by Darba et al where patients with HypoPT-related admissions spent a mean of 7.2 days in the hospital [ 24 ]. Similarly, the Italian study by Cipriani et al reported a mean LOS of 7.4 days for HypoPT-related hospitalizations between 2006 and 2013 [ 16 ].…”

Association of Hyperparathyroidism and Papillary Thyroid Cancer: A Multicenter Retrospective Study

“…The prevalence of primary hyperparathyroidism (pHPT) is 0.1% to 0.4% in the general population [ 1 ] and its incidence is increasing, leading to an increased need for surgical management [ 2 , 3 ]. Usually, it is caused by a solitary parathyroid adenoma and surgical resection is the choice of treatment [ 4 ].…”

The Relationship of Solitary Parathyroid Adenoma Volume with Pre- and Post-operative Parathormone and Calcium Levels

“…However, contrary to epidemiological studies, which demonstrate that the age-adjusted incidence of PHPT increases with age, the ages of our study population had clustered in the late 50 years. 10 This is due to the design of our study, which includes only patients operated for PHPT rather than being a population survey. Patient age being one of the indications for surgery and early postmenopausal women being more likely to undergo bone mineral density scanning than the elderly, resulting in increased diagnoses of asymptomatic osteoporosis, are possible reasons for the age distribution of our study population.…”