ArticleWorld journal of surgery2018
Patient Frailty Should Be Used to Individualize Treatment Decisions in Primary Hyperparathyroidism.
Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 26 citations in OpenAlex.
- Use and Implications of the Fracture Risk Assessment Tool in Primary Hyperparathyroidism.JAMA network open · 2026Article
- [Multimorbid patients in endocrine surgery].Chirurgie (Heidelberg, Germany) · 2025Article
- Focus on Non-osteoporotic Post-menopausal Women with Asymptomatic Primary Hyperparathyroidism: A Monocentric Series.Endocrine, metabolic & immune disorders drug targets · 2024Article
- Sex-Stratified Predictors of Prolonged Operative Time and Hospital Admission in Outpatient Parathyroidectomy.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2024Article
- Primary Hyperparathyroidism in Older Adults: A Narrative Review of the Most Recent Literature on Epidemiology, Diagnosis and Management.Journal of clinical medicine · 2023Review
- Older Patients With Asymptomatic Primary Hyperparathyroidism: Should Criteria for Surgery Be Expanded?Journal of the Endocrine Society · 2023Article
- The impact of patient age on practice patterns and outcomes for primary hyperparathyroidism.American journal of surgery · 2022Article
- Safety of parathyroidectomy in older vs. younger patients with primary hyperparathyroidism.Endocrine connections · 2021Article
- Article
- Surgical Management of Primary Hyperparathyroidism-Clinicopathologic Study of 1019 Cases from a Single Institution.Journal of clinical medicine · 2020Article
- Changes in bone mineral density after parathyroidectomy in patients with moderate to severe primary hyperparathyroidism.The Journal of international medical research · 2020Article
- Frailty is More Predictive than Age for Complications After Thyroidectomy for Multinodular Goiter.World journal of surgery · 2020Article
- Parathyroidectomy is Safe in Elderly Patients: A National Surgical Quality Improvement Program Study.World journal of surgery · 2020Article
- Recent advances in the understanding and management of primary hyperparathyroidism.F1000Research · 2020Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPrimary hyperparathyroidism (PHPT) is a common endocrine disorder that predominantly affects patients >60 and is increasing in prevalence. Identifying risk factors for poor outcomes after parathyroidectomy in older adults will help tailor operative decision making. The impact of frailty on surgical outcomes in parathyroidectomy has not been established.
methodsWe performed a retrospective review of patients ≥40 years who underwent parathyroidectomy in the 2005-2010 ACS NSQIP. Frailty was assessed using the modified frailty index (mFI). Multivariable regression was used to determine the association of frailty with 30-day complications, length of stay (LOS), and reoperation.
resultsWe identified 13,123 patients ≥40 who underwent parathyroidectomy for PHPT. The majority of patients were not frail, with 80% with a low NSQIP mFI score (0-1 frailty traits), 19% with an intermediate mFI score (2-3), and 0.9% with a high mFI score (≥4). Overall 30-day complications were rare, occurring in 141 (1.1%) patients. Increasing frailty was associated with an increased risk of complications with adjusted odds ratios (ORs) of 1.76 (95% CI 1.20-2.59; p = 0.004) for intermediate and 8.43 (95% CI 4.33-16.41; p < 0.001) for high mFI score. Patient age was independently associated with an increased risk of complications only when ≥75, as was African-American race. Anesthesia with local, monitored anesthesia care, or regional block was the only factor associated with decreased odds of complications. A high NSQIP mFI was also associated with a significant 4.77-day adjusted increase in LOS (95% CI 4.28-5.25; p < 0.001) and increased odds of reoperation (OR 4.20, 95% CI 1.64-10.74; p = 0.003).
conclusionPatient frailty is associated with increased complications, reoperation and prolonged LOS in patients undergoing parathyroidectomy for PHPT. The risks of surgical management should be weighed against potential benefits in frail patients with PHPT to individualize treatment decisions in this vulnerable population.
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