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Abstract：
Our retrospective database study investigates sex-stratified predictors of prolonged operative time (POT) and hospital admission following parathyroidectomy for primary hyperparathyroidism (PHPT). The 2016 to 2018 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was queried for patients with PHPT undergoing parathyroidectomy. Cases analyzed were all outpatient status, arrived from home, coded as non-emergent, and elective. POT was defined by the 75th percentile. Hospital admission was defined as LOS ≥ 1 day. Univariate and multivariable binary logistic regressions were utilized. Of 7442 cases satisfying inclusion criteria, the majority were female (78.0%) and White (78.5%). Median OT (IQR) for females and males was 77 (58-108) and 81 (61-109) minutes, respectively (P = 0.003). 1965 (33.9%) females and 529 (32.3%) males required hospital admission. Independent predictors of POT included ASA class III/IV (aOR 1.342, 95% CI 1.007-1.788) and obesity (aOR 1.427, 95% CI 1.095-1.860) for males (P < 0.05). Independent predictors of hospital admission included age (aOR 1.008, 95% CI 1.002-1.014), ASA class III/IV (aOR 1.490, 95% CI 1.301-1.706), obesity (aOR 1.309, 95% CI 1.151-1.489), dyspnea (aOR 1.394, 95% CI 1.041-1.865), chronic steroid use (aOR 1.674, 95% CI 1.193-2.351), and COPD (aOR 1.534, 95% CI 1.048-2.245) for females (P < 0.05); and ASA class III/IV (aOR 1.931, 95% CI 1.483-2.516) and bleeding disorder (aOR 2.752, 95% CI 1.443-5.247) for males (P < 0.005). In conclusion, predictors of POT and hospital admission following parathyroidectomy for PHPT differed by patient sex. Identifying patients at risk for POT and hospital admission may optimize healthcare resource utilization. Level of Evidence: IV.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-04444-3.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-04444-3.
摘要：
我们的回顾性数据库研究调查了原发性甲状旁腺功能亢进症（PHPT）的甲状旁腺切除术后延长手术时间（POT）和住院时间的性别分层预测因素。2016年至2018年美国外科医生学会国家外科质量改善计划（ACS-NSQIP）被询问接受甲状旁腺切除术的PHPT患者。病例分析均为门诊状态,从家里来的,编码为非紧急，和选修。POT由第75百分位数定义。入院定义为LOS≥1天。使用单变量和多变量二元逻辑回归。在满足纳入标准的7442例中，大多数是女性（78.0％）和白人（78.5％）。女性和男性的中位OT（IQR）为77（58-108）和81（61-109）分钟，分别为(P=0.003)。1965年（33.9％）女性和529（32.3％）男性需要住院。POT的独立预测因素包括男性的ASAIII/IV级（aOR1.342，95％CI1.007-1.788）和肥胖（aOR1.427，95％CI1.095-1.860）（P<0.05）。入院的独立预测因素包括年龄（aOR1.008，95％CI1.002-1.014），ASAIII/IV级（aOR1.490，95%CI1.301-1.706），肥胖（aOR1.309，95%CI1.151-1.489），呼吸困难（aOR1.394，95%CI1.041-1.865），长期使用类固醇（aOR1.674，95%CI1.193-2.351），女性的COPD（aOR1.534，95％CI1.048-2.245）（P<0.05）；男性的ASAIII/IV级（aOR1.931，95％CI1.483-2.516）和出血性疾病（aOR2.752，95％CI1.443-5.247）（P<0.005）。总之,PHPT甲状旁腺切除术后POT和入院的预测因素因患者性别而异。确定有POT和入院风险的患者可以优化医疗保健资源的利用。证据等级：IV。
■在线版本包含补充材料，可在10.1007/s12070-023-04444-3获得。
■在线版本包含补充材料，可在10.1007/s12070-023-04444-3获得。
