Table 1. Baseline Characteristics of Medicare Beneficiaries With Primary Hyperparathyroidism (2006-2017).
| Characteristic | Unadjusted, No. (%) | SMD | IPW-adjusted, %a | SMD | ||||
|---|---|---|---|---|---|---|---|---|
| Overall cohort | Parathyroidectomy | Nonoperative | Overall cohort | Parathyroidectomy | Nonoperative | |||
| Total No. | 210 206 | 63 136 | 147 070 | NA | 210 206 | 63 136 | 147 070 | NA |
| Sex | ||||||||
| Male | 44 569 (21.2) | 13 684 (21.7) | 30 885 (21.0) | −0.016 | 21.1 | 20.9 | 21.1 | 0.007 |
| Female | 165 637 (78.8) | 49 452 (78.3) | 116 185 (79.0) | 0.016 | 78.9 | 79.1 | 78.9 | −0.007 |
| Age group, y | ||||||||
| 66-75 | 117 960 (56.1) | 42 024 (66.6) | 75 936 (51.6) | −0.307 | 56.0 | 55.8 | 56.1 | 0.005 |
| 76-85 | 73 491 (35.0) | 19 010 (30.1) | 54 481 (37.0) | 0.147 | 35.1 | 35.2 | 35.0 | −0.005 |
| ≥86 | 18 755 (8.9) | 2102 (3.3) | 16 653 (11.3) | 0.310 | 8.9 | 8.9 | 8.9 | 0.000 |
| Race or ethnicity | ||||||||
| American Native | 453 (0.2) | 150 (0.2) | 303 (0.2) | −0.007 | 0.2 | 0.2 | 0.2 | −0.001 |
| Asian | 1953 (0.9) | 390 (0.6) | 1563 (1.1) | 0.049 | 0.9 | 1.0 | 0.9 | −0.005 |
| Black | 19 797 (9.4) | 4741 (7.5) | 15 056 (10.2) | 0.096 | 9.5 | 9.6 | 9.4 | −0.007 |
| Hispanic | 2280 (1.1) | 480 (0.8) | 1800 (1.2) | 0.047 | 1.1 | 1.1 | 1.1 | 0.000 |
| White | 183 433 (87.3) | 56 888 (90.1) | 126 545 (86.0) | −0.126 | 87.2 | 87.0 | 87.2 | 0.007 |
| Unknown | 2290 (1.1) | 487 (0.8) | 1803 (1.2) | 0.046 | 1.1 | 1.1 | 1.1 | 0.001 |
| ADI group | ||||||||
| Most advantaged | 52 899 (25.2) | 12 717 (20.1) | 40 182 (27.3) | 0.169 | 25.1 | 25.0 | 25.1 | 0.002 |
| Slightly advantaged | 68 471 (32.6) | 20 784 (32.9) | 47 687 (32.4) | −0.011 | 32.5 | 32.4 | 32.5 | 0.004 |
| Slightly disadvantaged | 65 887 (31.3) | 22 093 (35.0) | 43 794 (29.8) | −0.112 | 31.4 | 31.5 | 31.4 | −0.003 |
| Most disadvantaged | 22 949 (10.9) | 7542 (11.9) | 15 407 (10.5) | −0.047 | 11.0 | 11.1 | 10.9 | −0.005 |
| Geography | ||||||||
| Urban | 178 718 (85.0) | 51 689 (81.9) | 127 029 (86.4) | 0.123 | 84.9 | 84.9 | 85.0 | 0.003 |
| Rural | 31 488 (15.0) | 11 447 (18.1) | 20 041 (13.6) | −0.123 | 15.1 | 15.1 | 15.0 | −0.003 |
| Frailty | ||||||||
| Robust | 72 794 (34.6) | 24 450 (38.7) | 48 344 (32.9) | −0.122 | 34.7 | 34.8 | 34.7 | −0.004 |
| Prefrail | 109 087 (51.9) | 32 866 (52.1) | 76 221 (51.8) | −0.005 | 51.8 | 51.8 | 51.9 | 0.002 |
| Mildly frail | 19 462 (9.3) | 4041 (6.4) | 15 421 (10.5) | 0.147 | 9.3 | 9.3 | 9.3 | 0.000 |
| Moderately-to-severely frail | 8863 (4.2) | 1779 (2.8) | 7084 (4.8) | 0.104 | 4.2 | 4.1 | 4.2 | 0.005 |
| Charlson-Deyo Comorbidity Index score | ||||||||
| 0 | 47 672 (22.7) | 16 201 (25.7) | 31 471 (21.4) | −0.101 | 22.7 | 22.7 | 22.7 | −0.001 |
| 1 | 46 003 (21.9) | 14 515 (23.0) | 31 488 (21.4) | −0.038 | 21.9 | 22.0 | 21.9 | −0.002 |
| ≥2 | 116 531 (55.4) | 32 420 (51.3) | 84 111 (57.2) | 0.117 | 55.4 | 55.3 | 55.4 | 0.002 |
| Indications for parathyroidectomy | ||||||||
| History of osteoporosis | 91 122 (43.4) | 26 247 (41.6) | 64 875 (44.1) | 0.051 | 43.3 | 43.3 | 43.3 | 0.000 |
| History of kidney stones | 30 470 (14.5) | 11 197 (17.7) | 19 273 (13.1) | −0.128 | 14.4 | 14.3 | 14.4 | 0.003 |
| History of stage 3 CKD | 20 435 (9.7) | 4300 (6.8) | 16 135 (11.0) | 0.147 | 9.7 | 9.6 | 9.7 | 0.004 |
| Endocrinologist care ≤6 mo of diagnosis | 98 205 (46.7) | 35 546 (56.3) | 62 659 (42.6) | −0.277 | 46.8 | 47.0 | 46.7 | −0.005 |
| Fracture risk factors | ||||||||
| Prior fracture | 19 222 (9.1) | 4689 (7.4) | 14 533 (9.9) | 0.087 | 9.2 | 9.2 | 9.2 | −0.001 |
| Tobacco use | 9317 (4.4) | 3282 (5.2) | 6035 (4.1) | −0.052 | 4.4 | 4.4 | 4.4 | 0.001 |
| Alcohol abuse disorder | 1715 (0.8) | 457 (0.7) | 1258 (0.9) | 0.015 | 0.8 | 0.8 | 0.8 | −0.002 |
| Obesity | 23 916 (11.4) | 7541 (11.9) | 16 375 (11.1) | −0.025 | 11.3 | 11.3 | 11.4 | 0.003 |
Abbreviations: ADI, area deprivation index; CKD, chronic kidney disease; IPW, inverse probability weighted; SMD, standardized mean difference.
a
The propensity score used for IPW was based on all characteristics listed.