Predictors of operative failure in parathyroidectomy for primary hyperparathyroidism

Abstract Introduction Many 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 failu...

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Bibliographic Details
Published in:The American journal of surgery 2017-09, Vol.214 (3), p.509-514
Main Authors: Cron, David C, Kapeles, Steven R, Andraska, Elizabeth A, Kwon, Sebastian T, Kirk, Peter S, McNeish, Brendan L, Lee, Christopher S, Hughes, David T
Format: Article
Language:English
Subjects:
Biopsy
Calcium
Criteria
Decision making
Failure analysis
Female
Humans
Hypercalcemia
Hyperparathyroidism
Hyperparathyroidism, Primary - surgery
Identification methods
Localization
Male
Medical imaging
Middle Aged
Multivariate analysis
Operative failure
Parathyroid hormone
Parathyroidectomy
Patients
Persistent hypercalcemia
Primary hyperparathyroidism
Prognosis
Regression analysis
Retrospective Studies
Risk analysis
Risk Factors
Studies
Success
Surgeons
Surgery
Tomography
Treatment Failure
Tumors
Ultrasonic imaging
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Summary:Abstract Introduction Many 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. Methods This 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). Results Operative failure was identified in 67 patients (3.0%). The following variables were independently associated with operative failure on multivariate analysis: IOPTH criteria met (protective, OR = 0.22, P 
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2017.01.012