{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T12:26:30Z","timestamp":1778675190957,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Nearly 80% of chronic renal failure patients have secondary hyperparathyroidism. Cinacalcet is used to lower parathyroid hormone; however, it is expensive and has side effects. When secondary hyperparathyroidism is resistant to medication or medications are inaccessible, parathyroidectomy is performed. Race and socioeconomic status influence access to care and surgical outcomes. We sought to evaluate the effect of race and socioeconomic status on parathyroidectomy rate as well as surgical outcomes of patients with secondary hyperparathyroidism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We undertook cross\u2010sectional analysis of adults diagnosed with secondary hyperparathyroidism in the USA between 2012 and 2014, using the National Inpatient Sample. Univariate and multivariate analyses were used to determine associations between social disparities, likelihood to undergo parathyroidectomy, and surgical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2012 and 2014, a national estimate of 724,170 hospitalizations were identified where patients had a diagnosis of secondary hyperparathyroidism. Operative rate was 0.67%. By socioeconomic status, differences in rates of surgery in the poorest compared to the richest were not significant (0.74% vs. 0.55%, OR 1.08, <jats:italic>p<\/jats:italic>\u2009=\u20090.5). African\u2010American patients had higher rates of parathyroidectomy compared to Caucasians (1 vs. 0.74%, OR 1.49, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). African\u2010American patients also had a trend toward more complications and greater length of stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>According to a large administrative dataset, parathyroidectomy for secondary hyperparathyroidism is seldom used in the USA. African\u2010American patients have higher rates of surgical management. Surgical outcomes may be affected by race. Clinicians treating secondary hyperparathyroidism should be aware of existing disparities within their health system.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05207-4","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T01:59:50Z","timestamp":1569895190000},"page":"537-543","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Effects of Social Disparities on Management and Surgical Outcomes for Patients with Secondary Hyperparathyroidism"],"prefix":"10.1002","volume":"44","author":[{"given":"Brittany","family":"Greene","sequence":"first","affiliation":[{"name":"Division of General Surgery, Department of Surgery University Health Network Toronto General Hospital, 10 En 214, 200 Elizabeth Street M5G 2C4 Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Joseph","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine University Health Network 585 University Avenue, 11\u2010PMB\u2010129 M5G 2N2 Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen P.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Harvard School of Public Health Beth Israel Deaconess Medical Center, 330 Brookline Avenue 02215 Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse D.","family":"Pasternak","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery University Health Network Toronto General Hospital, 10 En 214, 200 Elizabeth Street M5G 2C4 Toronto ON 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