Population-level predictors of persistent hyperparathyroidism

Yeh, Michael W.; Wiseman, James E.; Chu, Stephanie; Ituarte, Philip H.G.; Liu, In‐Lu Amy; Young, Kraig L.; Kang, Steven J.; Harari, Avital; Haigh, Philip I.

doi:10.1016/j.surg.2011.09.025

Cited by 46 publications

(37 citation statements)

References 23 publications

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“…This overall success rate is likely reflective of those found in general community practice. 9 As enrollees in an integrated medical system, Kaiser patients stay predominantly within Kaiser facilities for all of their health care needs and referral outside of the system is rare. As an alternative strategy, it may be beneficial to identify high-volume parathyroid surgeons within the Kaiser network.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, long-term follow-up was possible in a large fraction of patients because two-thirds of subscribers maintain membership for ≥5 years. 9 …”

Section: Discussionmentioning

confidence: 99%

“…9 Hence, the clinical consequences of FPTx remain obscure. We previously have used electronic screening of biochemical follow-up data on patients who have undergone PTx to accurately assess the rate of persistent and recurrent PHPT within a large population.…”

mentioning

confidence: 99%

“…We previously have used electronic screening of biochemical follow-up data on patients who have undergone PTx to accurately assess the rate of persistent and recurrent PHPT within a large population. 9 The aim of this study was to examine skeletal outcomes in patients who have undergone FPTx in comparison with those who have undergone successful PTx (SPTx), as well as patients who were managed nonoperatively. We hypothesize that patients undergoing FPTx will have outcomes similar to those in the observation group.…”

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confidence: 99%

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Skeletal effects of failed parathyroidectomy

Zheng

Zhou

et al. 2018

Surgery

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Background. Parathyroidectomy improves bone mineral density and decreases risk for fracture in patients with primary hyperparathyroidism. The aim of this study was to determine skeletal consequences of failed parathyroidectomy. Methods. A retrospective, cohort study of patients with biochemically confirmed primary hyperparathyroidism within a vertically integrated health system was performed (1995–2014). Failed parathyroidectomy was defined by hypercalcemia within 6 months of initial parathyroidectomy. Time-varying Cox regression was used to estimate the risk for any fracture and hip fracture in 3 comparison groups: observation, successful parathyroidectomy, and failed parathyroidectomy. Bone mineral density changes also were compared. Results. The cohort included 7,169 patients, of whom 5,802 (81%) were observed, 1,228 underwent successful parathyroidectomy (17%), and 137 underwent failed parathyroidectomy (2%). The adjusted risk for any fracture (hazard ratio, 1.28; 95% confidence interval, 0.85–1.92) and hip fracture (hazard ratio, 1.63: 95% CI, 0.77–3.45) associated with failed parathyroidectomy was similar to that associated with observation. Successful parathyroidectomy was associated with a decrease in any fracture (hazard ratio, 0.68; 95% confidence interval, 0.57–0.82) and hip fracture (hazard ratio, 0.43; 95% confidence interval, 0.27–0.68) compared with observation. Bone mineral density changes in the failed parathyroidectomy group paralleled those associated with observation. Conclusion. Failed parathyroidectomy is associated with a high risk for fracture similar to that seen with observation.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, long-term follow-up was possible in a large fraction of patients because two-thirds of subscribers maintain membership for ≥5 years. 9 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Skeletal effects of failed parathyroidectomy

Zheng

Zhou

et al. 2018

Surgery

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“…[1][2][3][4] A fraction of these patients ultimately undergo reoperation. 5 Factors contributing to the increased difficulty of reoperative parathyroidectomy (RPTx) include fibrosis and scarring, which distort tissue planes and make visual and tactile identification of parathyroid tissue more difficult. 2,6 Higher rates of complications such as recurrent laryngeal nerve injury and hypoparathyroidism have also been associated with RPTx.…”

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confidence: 99%

Dynamic Parathyroid Computed Tomography (4DCT) Facilitates Reoperative Parathyroidectomy and Enables Cure of Missed Hyperplasia

et al. 2015

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American Head and Neck Society Endocrine Surgery Section update on parathyroid imaging for surgical candidates with primary hyperparathyroidism

Zafereo

Angelos

et al. 2019

Head & Neck

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Health care consumer organizations and insurance companies increasingly are scrutinizing value when considering reimbursement policies for medical interventions. Recently, members of several American Academy of Otolaryngology-Head & Neck Surgery (AAO-HNS) committees worked closely with one insurance company to refine reimbursement policies for preoperative localization imaging in patients undergoing surgery for primary hyperparathyroidism. This endeavor led to an AAO-HNS parathyroid imaging consensus statement (https://www.entnet.org/ content/parathyroid-imaging). The American Head and Neck Society Endocrine Surgery Section gathered an expert panel of authors to delineate imaging options

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Population-level predictors of persistent hyperparathyroidism

Cited by 46 publications

References 23 publications

Skeletal effects of failed parathyroidectomy

Skeletal effects of failed parathyroidectomy

Dynamic Parathyroid Computed Tomography (4DCT) Facilitates Reoperative Parathyroidectomy and Enables Cure of Missed Hyperplasia

American Head and Neck Society Endocrine Surgery Section update on parathyroid imaging for surgical candidates with primary hyperparathyroidism

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