World Journal of Surgery

, Volume 43, Issue 2, pp 534–539 | Cite as

Risk Factors for Readmission After Parathyroidectomy for Renal Hyperparathyroidism

  • Justin D. Lee
  • Eric J. Kuo
  • Lin Du
  • Michael W. Yeh
  • Masha J. Livhits
Original Scientific Report (including Papers Presented at Surgical Conferences)



Patients with renal hyperparathyroidism (RHPT) are susceptible to major electrolyte fluctuations following parathyroidectomy, which may predispose them to early readmission. The purpose of this study is to evaluate risk factors for readmission in patients undergoing parathyroidectomy for RHPT.


Patients with renal failure who underwent parathyroidectomy were abstracted from the California Office of Statewide Health Planning and Development (1999–2012). Multivariable logistic regression was used to identify risk factors for readmission within 30 days of discharge.


The cohort included 4411 patients, of whom 17% were readmitted. Procedures included subtotal parathyroidectomy (74% of cases) and total parathyroidectomy with autotransplantation (26%). Median time to readmission was 9 days (interquartile range 4–16 days). Electrolyte disturbances including hypocalcemia were present in 36% of readmissions and were the most common cause for readmission. Independent risk factors for readmission included Black race [odds ratio (OR) 1.26, 95% confidence interval (CI) 1.00–1.57], Hispanic race (OR 1.38, 95% CI 1.12–1.71), disposition with home health (OR 1.94, 95% CI 1.35–2.77), disposition to a skilled nursing facility (OR 2.30, 95% CI 1.58–3.35), and total parathyroidectomy with autotransplantation (OR 1.27, 95% CI 1.06–1.52). Advancing age (OR 0.98, 95% CI 0.98–0.99) and surgery at a high-volume hospital (OR 0.53, 95% CI 0.36–0.77) were protective against readmission.


Patients undergoing parathyroidectomy for RHPT have a high readmission rate, most frequently for metabolic complications. Increased postoperative vigilance, which may include outpatient laboratory monitoring, may be indicated in patients with risk factors for readmission.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

268_2018_4823_MOESM1_ESM.docx (25 kb)
Supplementary material 1 (DOCX 24 kb)


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Justin D. Lee
    • 1
  • Eric J. Kuo
    • 1
  • Lin Du
    • 2
  • Michael W. Yeh
    • 1
  • Masha J. Livhits
    • 1
  1. 1.Section of Endocrine SurgeryUCLA David Geffen School of MedicineLos AngelesUSA
  2. 2.Department of BiomathematicsUCLA David Geffen School of MedicineLos AngelesUSA

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