Non-adherence to consensus guidelines on preoperative imaging in surgery for primary hyperparathyroidism

Milou E. Noltes, Stephan Brands, Rudi A. J. O. Dierckx, Pieter L. Jager, Wendy Kelder, Adrienne H. Brouwers, Anne Brecht Francken, Schelto Kruijff*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objective: The aim of this study was to determine the adherence to consensus guidelines on preoperative imaging of patients with primary hyperparathyroidism (pHPT) in real local practice.

Methods: This was a retrospective multicenter cohort study of 411 patients undergoing parathyroidectomy for pHPT from 2007 to 2017 in three referral centers.

Results: In 286/411 patients (69%) the preoperative imaging workup adhered to guidelines (utilizing ultrasound and parathyroid scintigraphy). In patients in whom guidelines were followed 63% were discharged within one day versus 37% in whom guidelines were not followed (P< .0005). The use of a bimodality imaging workup, starting with ultrasound and parathyroid scintigraphy followed by imaging upscaling aiming for anatomical and functional concordance, was a predictor for the performance of a minimally invasive parathyroidectomy (OR 4.098, 95% CI 2.296-7.315,P< .0005).

Conclusion: The level of compliance to preoperative imaging guidelines is suboptimal in this population. Patients in whom adherence was achieved showed a shorter length of stay. More education of physicians is required regarding the appropriate preoperative imaging workup in pHPT.

Original languageEnglish
Pages (from-to)1247-1253
Number of pages7
JournalLaryngoscope investigative otolaryngology
Volume5
Issue number6
DOIs
Publication statusPublished - Dec-2020

Keywords

  • adherence
  • endocrine surgery
  • guideline
  • preoperative imaging
  • primary hyperparathyroidism
  • MANAGEMENT

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