Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5730986 | The American Journal of Surgery | 2017 | 6 Pages |
IntroductionMany adjuncts guide surgical decision making in parathyroidectomy, yet their independent associations with outcome are poorly characterized. We examined a broad range of perioperative factors and used multivariate techniques to identify independent predictors of operative failure (persistent disease) after parathyroidectomy.MethodsThis was a retrospective review of 2239 patients with primary hyperparathyroidism who underwent parathyroidectomy at a single-center from 1999 to 2014. We used multivariate logistic regress to measure associations between multiple perioperative factors and an operative failure (persistent hypercalcemia).ResultsOperative failure was identified in 67 patients (3.0%). The following variables were independently associated with operative failure on multivariate analysis: IOPTH criteria met (protective, ORÂ =Â 0.22, PÂ <Â 0.001), preoperative calcium (risk factor, ORÂ =Â 2.27 per unit increase, PÂ <Â 0.001), weight of excised gland(s) (protective, ORÂ =Â 0.70 per two-fold increase, PÂ =Â 0.003), and preoperative PTH (protective, ORÂ =Â 0.55 per two-fold increase, PÂ =Â 0.008).ConclusionIn addition to the well-established IOPTH criteria, we suggest that consideration of the above independent perioperative risk factors may further inform surgical decision-making in parathyroidectomy.