| Parathyroidectomy in the Elderly: Analysis of 7313 Patients. | |
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MedLine Citation:
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PMID: 21571309 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The elderly are the fastest growing subset of the U.S. population, and suffer most from primary hyperparathyroidism. This is the first multi-institutional study to characterize 30-d outcomes in elderly patients undergoing parathyroidectomy. MATERIALS AND METHODS: Patients who underwent parathyroidectomy for primary hyperparathyroidism in ACS-NSQIP, 2005-8, were stratified into age groups: 45-64, 65-79, and ≥80 y. Independent patient variables included gender, race, inpatient/outpatient type, anesthesia, ASA classification, functional status, and presence/absence of >30 conditions. Outcomes included overall/system-specific complications, return to the OR, operating times, LOS, 30-d mortality. Patients 65-79 and ≥80 y were compared with younger ones using multivariable linear and logistic regression. RESULTS: A total of 7313 patients were identified: 77.8% women, 77.2% White, and 95.6% underwent first-time parathyroidectomy. Patients 65-79 and ≥ 80y were more likely to have inpatient parathyroidectomies compared with younger patients (42.4%, 46.8% versus 36.0%) and higher ASA classification (42.4%, 59.8% versus 24.2%, all P < 0.01). Patients ≥ 80 y were less likely than those 45-64 y to receive general anesthesia (84.9% versus 89.8%, P < 0.01). Patients ≥ 65 y were more likely to have ≥1 complication (2.2% versus 1.3%, P < 0.01) and respiratory-specific complications compared with younger patients (0.9% versus 0.3%, P < 0.01). Patients 65-79 and ≥80 y were more likely to have extended hospital stays (7.7%, 12.2% versus 6.5%, P < 0.01); mortality rate for patients ≥ 80 y was higher (0.8% versus <0.1%, P < 0.01). On multivariable analysis, patients ≥ 65 y had increased risks for overall/respiratory complications and extended hospital stays, (all P < 0.01). CONCLUSIONS: Elderly patients sustain more morbidity following parathyroidectomy. Advanced age may be an independent risk factor worth considering in surgical decision-making. |
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Authors:
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Daniel C Thomas; Sanziana A Roman; Julie A Sosa |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-31 |
Journal Detail:
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Title: The Journal of surgical research Volume: - ISSN: 1095-8673 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-5-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376340 Medline TA: J Surg Res Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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SUNY Upstate Medical University, Syracuse, New York. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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