Abstract
Background
The risk of postoperative hungry bone syndrome after parathyroidectomy for secondary
hyperparathyroidism of renal origin may alter the course of treatment, including the
hospital length of stay and readmission rates. We sought to identify additional patient
or hospital factors that might contribute to hungry bone syndrome after parathyroidectomy
in patients with secondary hyperparathyroidism of renal origin.
Methods
Patients who underwent a parathyroidectomy for secondary hyperparathyroidism of renal
origin were identified in a geographically diverse, 10-state, discharge data set.
Covariates included demographic data, payer status, 31 comorbidities, and hospital
characteristics. The primary outcome variable of interest was hospital length of stay.
Secondary outcomes were complications and 30-day readmission.
Results
Of 796 patients studied, 164 patients (20.6%) were diagnosed with hungry bone syndrome.
There were no differences in the rates of hungry bone syndrome by race or number of
comorbidities. The average age of hungry bone syndrome patients (45.7 years ± 13.9)
was younger than that of non–hungry bone syndrome patients (50.7 ± 14.8; P < .001). Hungry bone syndrome was more common among obese patients than nonobese
patients (25.0% vs 15.8%; P < .001). Parathyroid autotransplant was performed at similar rates in hungry bone
syndrome and non–hungry bone syndrome patients (23.8% vs 23.1%; P = .821). Median length of stay was significantly longer for hungry bone syndrome
patients (6 days, interquartile range: [4, 8] versus 3 days, interquartile range:
[2–6]; P < .001). Similar 30-day readmission rates were observed (hungry bone syndrome: 41
(25%) versus non–hungry bone syndrome: 147 (23%); P = .640).
Conclusion
Hungry bone syndrome occurs in 1 of 5 patients after parathyroidectomy for secondary
hyperparathyroidism of renal origin. Patients should be informed of the possibility
of a relatively long (6 days) length of stay after surgery as well as the moderate
possibility (>20%) of another hospitalization within the 30-day postdischarge period.
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Article info
Publication history
Published online: September 06, 2021
Accepted:
August 5,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
