Department of Economics, Universitat de Barcelona, Barcelona, Spain.
Department of Health Economics, BCN Health Economics & Outcomes Research S.L, Barcelona, Spain.
PLoS One. 2020 Mar 10;15(3):e0230130. doi: 10.1371/journal.pone.0230130. eCollection 2020.
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.
甲状旁腺疾病是一种罕见的病症，其发病率在不同人群中差异很大。它对钙稳态的直接影响会导致各种症状，这些症状会影响骨骼重塑等过程。本研究旨在提供 2003 年至 2017 年期间西班牙因甲状旁腺疾病住院患者的流行病学和特征数据，并分析疾病管理和直接医疗费用。通过西班牙卫生部从全国性住院患者数据库中提取了甲状旁腺疾病作为入院病因的医疗记录。共获得 12903 例患者的记录，女性患者（74.70%）和甲状旁腺功能亢进症患者（90.23%）居多。在研究期间，每年因甲状旁腺疾病住院的患者人数有所增加，同时这些疾病的发病率也有所增加。2017 年甲状旁腺功能亢进症的发病率为每 10000 人 2.95 例，女性为每 10000 人 4.03 例，男性为每 10000 人 1.37 例；同年，甲状旁腺功能减退症的发病率为每 10000 人 0.17 例。甲状旁腺功能减退症患者的住院时间明显延长（7.16 天），主要因急症入院。继发性和三发性甲状旁腺功能亢进症和甲状旁腺功能减退症患者的住院诊断中，心力衰竭的比例超过 20%，而最后一组的矿物质代谢紊乱程度最高。所有原发性甲状旁腺功能亢进症患者中，有 78.95%进行了甲状旁腺切除术。由于与甲状旁腺功能亢进症相关的费用增加，甲状旁腺疾病的年直接医疗费用在研究期间有所增加，而每位患者的费用相对稳定，甲状旁腺功能亢进症、甲状旁腺功能减退症和其他甲状旁腺疾病患者的平均费用分别为 3748 欧元、3430 欧元和 3737 欧元。本研究提供了关于西班牙甲状旁腺疾病流行病学和管理的新数据，扩展了现有关于甲状旁腺疾病的有限知识。
