Surgical treatment of hyperparathyroidism improves health-related quality of life

Abstract

Hypothesis: The surgical treatment of primary hyperparathyroidism results in an improved health-related quality of life.

Design: Prospective cohort analysis of consecutive patients with primary hyperparathyroidism analyzed preoperatively and 1 year postoperatively.

Setting: Academic multispecialty referral clinic.

Patients: We prospectively evaluated 74 consecutive patients who underwent parathyroid exploration for primary hyperparathyroidism during a 15-month period.

Interventions: The Medical Outcomes Study Short-Form Health Survey (SF-36) was administered before consultation with a surgeon. Patients were categorized based on reason for referral as either asymptomatic (group 1; n = 43) or symptomatic (group 2; n = 29). All patients underwent parathyroid exploration and normalization of calcium levels postoperatively. The SF-36 was then re-administered after 1 year.

Main outcome measures: Statistical analysis of preoperative and postoperative SF-36 scores, and comparisons with national norms.

Results: The SF-36 was completed preoperatively and 1 year postoperatively by 72 (97%) of 74 patients. When the results were compared with published national norms, the preoperative population was significantly impaired in 5 of 8 domains, whereas the postoperative one had improved and was nearly indistinguishable from the norm. In 7 of 8 domains, the postoperative scores were significantly improved compared with preoperative scores. Group 1 patients showed significant preoperative impairment in 3 domains and significantly improved in 2, whereas group 2 patients showed significant impairment and improvement in 7 domains.

Conclusion: The surgical treatment of primary hyperparathyroidism is associated with durable, statistically significant improvements in health-related quality of life.