Testing for Primary Hyperparathyroidism in 17,491 Patients With Hypercalcemia.
In: Journal of Surgical Research, Jg. 296 (2024-04-01), S. 456-464
academicJournal
Zugriff:
Primary hyperparathyroidism (PHPT) is underdiagnosed and associated with many adverse health effects. Historically, many hypercalcemic patients have not received parathyroid hormone (PTH) testing; however, underlying reasons are uncertain. Our goals are to determine the PTH testing rate among hypercalcemic individuals at a large academic health system and to assess for characteristics associated with testing versus not testing for PHPT to inform future strategies for closing testing gaps. This retrospective study included adult patients with ≥1 elevated serum calcium result between 2018 and 2022. Based on the presence or absence of a serum PTH result, individuals were classified as "screened" versus "unscreened" for PHPT. Demographic and clinical characteristics of these groups were compared. The sample comprised 17,491 patients: 6567 male (37.5%), 10,924 female (62.5%), mean age 59 y. PTH testing was performed in 6096 (34.9%). Characteristics independently associated with the greatest odds of screening were 5+ elevated calcium results (odds ratio [OR] 5.02, P < 0.0001), chronic kidney disease (OR 3.63, P < 0.0001), maximum calcium >12.0 mg/dL (OR 2.48, P < 0.0001), and osteoporosis (OR 2.42, P < 0.0001). Characteristics associated with lowest odds of screening were age <35 y (OR 0.60, P < 0.0001), death during the study period (OR 0.68, P < 0.0001), age ≥85 y (OR 0.70, P = 0.0007), and depression (OR 0.84; P = 0.0081). Only 35% of hypercalcemic patients received PTH testing. Although the presence of PHPT-associated morbidity was generally associated with increased rates of screening, hypercalcemic patients with depression were 16% less likely to be tested. [ABSTRACT FROM AUTHOR]
Titel: |
Testing for Primary Hyperparathyroidism in 17,491 Patients With Hypercalcemia.
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Autor/in / Beteiligte Person: | Bunch, Paul M. ; Rigdon, Joseph ; Lenchik, Leon ; Gorris, Matthew A. ; Randle, Reese W. |
Zeitschrift: | Journal of Surgical Research, Jg. 296 (2024-04-01), S. 456-464 |
Veröffentlichung: | 2024 |
Medientyp: | academicJournal |
ISSN: | 0022-4804 (print) |
DOI: | 10.1016/j.jss.2024.01.020 |
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