Testing for Primary Hyperparathyroidism in 17,491 Patients With Hypercalcemia
Copyright © 2024 Elsevier Inc. All rights reserved..
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:296 |
|---|---|
| Enthalten in: |
The Journal of surgical research - 296(2024) vom: 18. März, Seite 456-464 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bunch, Paul M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Calcium |
|---|
| Anmerkungen: |
Date Completed 19.03.2024 Date Revised 19.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jss.2024.01.020 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368097420 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368097420 | ||
| 003 | DE-627 | ||
| 005 | 20240319232606.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240207s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jss.2024.01.020 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1336.xml |
| 035 | |a (DE-627)NLM368097420 | ||
| 035 | |a (NLM)38320365 | ||
| 035 | |a (PII)S0022-4804(24)00041-6 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bunch, Paul M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Testing for Primary Hyperparathyroidism in 17,491 Patients With Hypercalcemia |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 19.03.2024 | ||
| 500 | |a Date Revised 19.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: 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 | ||
| 520 | |a METHODS: 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 | ||
| 520 | |a RESULTS: 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) | ||
| 520 | |a CONCLUSIONS: 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diagnosis | |
| 650 | 4 | |a Hypercalcemia | |
| 650 | 4 | |a Parathyroid adenoma | |
| 650 | 4 | |a Parathyroid hormone | |
| 650 | 4 | |a Primary hyperparathyroidism | |
| 650 | 4 | |a Testing | |
| 650 | 7 | |a Calcium |2 NLM | |
| 650 | 7 | |a SY7Q814VUP |2 NLM | |
| 650 | 7 | |a Parathyroid Hormone |2 NLM | |
| 700 | 1 | |a Rigdon, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Lenchik, Leon |e verfasserin |4 aut | |
| 700 | 1 | |a Gorris, Matthew A |e verfasserin |4 aut | |
| 700 | 1 | |a Randle, Reese W |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of surgical research |d 1961 |g 296(2024) vom: 18. März, Seite 456-464 |w (DE-627)NLM000042676 |x 1095-8673 |7 nnns |
| 773 | 1 | 8 | |g volume:296 |g year:2024 |g day:18 |g month:03 |g pages:456-464 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jss.2024.01.020 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 296 |j 2024 |b 18 |c 03 |h 456-464 | ||