Patient‐based Surgical Outcome Tool Demonstrating Alleviation of Symptoms following Parathyroidectomy in Patients with Primary Hyperparathyroidism

• Published in: World journal of surgery Vol. 26; no. 8; pp. 942 - 949
• Main Authors: Pasieka, Janice L., Parsons, Louise L., Demeure, Michael J., Wilson, Stuart, Malycha, Peter, Jones, Jean, Krzywda, Beth
• Format: Journal Article
• Language: English
• Published: New York Springer‐Verlag 01-08-2002; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Comparison Group; Female; Health Status; Humans; Hyperparathyroidism; Hyperparathyroidism - psychology; Hyperparathyroidism - surgery; Male; Middle Aged; Outcome Assessment (Health Care) - methods; Parathyroidectomy; Postoperative Period; Preoperative Symptom; Primary Hyperparathyroidism; Prospective Studies; Quality of Life; Surgical Outcome; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-002-6623-y

This study assessed the impact of parathyroidectomy on the preoperative symptoms of patients with primary hyperparathyroidism (1° HPT) using a surgical outcome tool designed specifically for HPT. The multicenter nature of this study allowed us to validate further this disease‐specific outcome tool. 1° HPT patients from Canada, the United States, and Australia filled out the questionnaire preoperatively and postoperatively on day 7 and at 3 and
12 months. The symptoms recorded by the patients were expressed as parathyroidectomy assessment of symptoms (PAS) scores: the higher the score, the more symptomatic is the patient. Quality of Life (QOL) and self‐rated health uni‐scales were included. Altogether, 203 patients with 1° HPT were enrolled; 27 from center A, 54 from center B, and 122 from center C; 58
nontoxic thyroid patients were enrolled for comparison. The comparison group had no significant change in their PAS scores throughout the study (scores 184, 215, 156, 186). All three centers demonstrated a significant reduction in symptoms following surgery. The median preoperative PAS score from center B patients was 282. Following surgery, PAS scores decreased significantly: 136, 58, 0
(p <0.05). Center C patients had a median preoperative PAS score of 344, decreasing postoperatively to 228 (p
<0.05) and continuing to decrease to 190, then 180. Center A also demonstrated a significant reduction in symptoms at 3 months, from 510
preoperatively to 209 (p <0.001). Both QOL and self‐rated health improved in the HPT patients, whereas no change was found in the comparison group following surgery. PAS scores are a reliable, disease‐specific measure of symptoms seen with HPT.
Parathyroidectomy significantly reduces these preoperative symptoms,
and this change translated into an improved health‐related QOL for the patients.