# Surgical Subspecialty and Parathyroidectomy Outcomes: A National Analysis

## TL;DR

This study analyzed national data to compare outcomes of parathyroidectomy surgeries performed by general surgeons versus otolaryngologists.

## Contribution

The study reveals that surgical subspecialty affects operation time but not complication rates in parathyroidectomy.

## Key findings

- Otolaryngologists had lower rates of unplanned reoperation and readmission compared to general surgeons.
- Otolaryngologist-performed surgeries had longer operation times after adjusting for confounders.
- No significant differences were found in mortality or major complications between the two specialties.

## Abstract

Parathyroidectomy (PT) is commonly performed for hyperparathyroidism. We investigated the association between surgical subspecialty and adverse outcomes in patients undergoing PT.

This retrospective cohort analysis utilized the 2005–2018 National Surgery Quality Improvement Program (NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify cases with a primary procedure of PT. Demographics, comorbidities, and complication incidences were compared between patients undergoing surgery by general surgeons or otolaryngologists using chi-square analyses. The independent effect of surgical subspecialty on adverse outcomes was analyzed using binary logistic regression.

49,667 (86.7%) PT performed by general surgeons and 7,595 (13.3%) by otolaryngologists were identified from 2005 to 2018. Chi-square analysis indicated that general surgery patients had lower incidences of obesity (42.0% vs. 44.6%; p < 0.001) and higher incidences of diabetes mellitus (8.1% vs. 5.8%; p < 0.001). Demographic characteristics that significantly differed between cohorts included race (p < 0.001) and age (p < 0.001). Unadjusted analyses indicated that otolaryngologist-performed PT had lower incidences of unplanned reoperation (0.9% vs. 1.1%; p = 0.048) and unplanned readmission (2.9% vs. 3.6%; p = 0.009). After adjusting for confounders, logistic regression analyses indicated that otolaryngologist-performed PT had increased odds of prolonged operation time (OR 1.605; 95% CI 1.475–1.746; p < 0.001). Significant differences in mortality, medical complications, and surgical complications were not found.

Surgical subspecialty is associated with PT operative time but is not associated with perioperative complications.

The online version contains supplementary material available at 10.1007/s12070-025-05436-1.