Patient Factors Associated With Parathyroidectomy in Older Adults With Primary Hyperparathyroidism.

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Parathyroidectomy provides definitive management for primary hyperparathyroidism (PHPT), reducing the risk of subsequent fracture, nephrolithiasis, and chronic kidney disease (CKD), but its use among older adults in the US is unknown.To identify patient characteristics associated with the use of parathyroidectomy for the management of PHPT in older adults.This population-based, retrospective cohort study used 100% Medicare claims from beneficiaries with an initial diagnosis of PHPT from January 1, 2006, to December 31, 2016. Patients were considered to meet consensus guideline criteria for parathyroidectomy based on diagnosis codes indicating osteoporosis, nephrolithiasis, or stage 3 CKD. Multivariable logistic regression was used to identify patient characteristics associated with parathyroidectomy. Data were analyzed from February 11, 2020, to October 8, 2020.The primary outcome was parathyroidectomy within 1 year of diagnosis.Among 210 206 beneficiaries with an incident diagnosis of PHPT (78.8% women; mean [SD] age, 75.3 [6.8] years), 63 136 (30.0%) underwent parathyroidectomy within 1 year of diagnosis. Among the subset of patients who met consensus guideline criteria for operative management (n = 131 723), 38 983 (29.6%) were treated with parathyroidectomy. Patients treated operatively were younger (mean [SD] age, 73.5 [5.7] vs 76.0 [7.1] years) and more likely to be White (90.1% vs 86.0%), to be robust or prefrail (92.1% vs 85.7%), and to have fewer comorbidities (Charlson Comorbidity Index score of 0 or 1, 54.6% vs 44.1%), in addition to being more likely to live in socioeconomically disadvantaged (46.9% vs 40.3%) and rural (18.1% vs 13.6%) areas (all P 

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This is an abstract of the clinical research article “Patient Factors Associated With Parathyroidectomy in Older Adults With Primary Hyperparathyroidism.” This clinical research article was published in the medical journal JAMA surgery on 2021-01-06 and has been categorised as belonging to the clinical specialty of General Surgery. To read the full clinical research article or obtain a PDF (if available) use the links directly above. To discover more of the latest General Surgery clinical research articles from the medical journal JAMA surgery please click the link below. For more of the latest General Surgery research articles from other leading medical journals click the link that says General Surgery next to the stethoscope icon at the top of the page. You can further filter clinical research articles by sub-specialties within General Surgery using the navigation menu at the top of the page.