Kim Sun Moon, Shu Aimee D, Long Jin, Montez-Rath Maria E, Leonard Mary B, Norton Jeffrey A, Chertow Glenn M
Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America.
Division of Endocrinology, Gerontology and Metabolism, Stanford University School of Medicine, Stanford, California, United States of America.
PLoS One. 2016 Aug 16;11(8):e0161192. doi: 10.1371/journal.pone.0161192. eCollection 2016.
Parathyroidectomy is the only curative therapy for patients with primary hyperparathyroidism. However, the incidence, correlates and consequences of parathyroidectomy for primary hyperparathyroidism across the entire US population are unknown. We evaluated temporal trends in rates of inpatient parathyroidectomy for primary hyperparathyroidism, and associated in-hospital mortality, length of stay, and costs. We used the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) from 2002-2011. Parathyroidectomies for primary hyperparathyroidism were identified using International Classification of Diseases, Ninth Revision codes. Unadjusted and age- and sex- adjusted rates of inpatient parathyroidectomy for primary hyperparathyroidism were derived from the NIS and the annual US Census. We estimated 109,583 parathyroidectomies for primary hyperparathyroidism between 2002 and 2011. More than half (55.4%) of patients were younger than age 65, and more than three-quarters (76.8%) were female. The overall rate of inpatient parathyroidectomy was 32.3 cases per million person-years. The adjusted rate decreased from 2004 (48.3 cases/million person-years) to 2007 (31.7 cases/million person-years) and was sustained thereafter. Although inpatient parathyroidectomy rates declined over time across all geographic regions, a steeper decline was observed in the South compared to other regions. Overall in-hospital mortality rates were 0.08%: 0.02% in patients younger than 65 years and 0.14% in patients 65 years and older. Inpatient parathyroidectomy rates for primary hyperparathyroidism have declined in recent years.
甲状旁腺切除术是原发性甲状旁腺功能亢进患者的唯一治愈性疗法。然而，在美国全体人群中，原发性甲状旁腺功能亢进患者接受甲状旁腺切除术的发生率、相关因素及后果尚不清楚。我们评估了原发性甲状旁腺功能亢进患者住院甲状旁腺切除术的时间趋势，以及相关的住院死亡率、住院时间和费用。我们使用了2002年至2011年医疗保健成本与利用项目全国住院患者样本（NIS）。通过国际疾病分类第九版编码识别原发性甲状旁腺功能亢进的甲状旁腺切除术。原发性甲状旁腺功能亢进患者住院甲状旁腺切除术的未调整率以及年龄和性别调整率来自NIS和美国年度人口普查。我们估计2002年至2011年间有109,583例原发性甲状旁腺功能亢进的甲状旁腺切除术。超过一半（55.4%）的患者年龄小于65岁，超过四分之三（76.8%）为女性。住院甲状旁腺切除术的总体发生率为每百万人年32.3例。调整率从2004年（每百万人年48.3例）降至2007年（每百万人年31.7例），此后保持稳定。尽管所有地理区域的住院甲状旁腺切除术率随时间下降，但与其他地区相比，南部地区的下降更为明显。总体住院死亡率为0.08%：65岁以下患者为0.02%，65岁及以上患者为0.14%。近年来，原发性甲状旁腺功能亢进患者的住院甲状旁腺切除术率有所下降。
