Causes of death in patients previously operated on for primary hyperparathyroidism

Out of 334 patients operated on for PHPT in the years 1956-79, 34 (10.2%) had died before the end of the year 1980. In the sex and age matched control material of 334 patients operated on at the same time for varicose veins, appendicitis or haemorrhoids the mortality was 21 (6.3%). The difference in mortality between these groups was statistically significant (p less than 0.05). The mean age at death of the PHPT patients was 65 years and that of the control patients 67 years. The PHPT patients who died differed from the whole PHPT material in higher mean age at operation (61 years v. 53 years), higher preoperative serum calcium values (3.31 mmol/l v. 3.08 mmol/l), more frequently elevated serum creatine preoperatively (44% v. 17%) and higher mean weight of the removed adenomas (3300 mg v. 2000 mg). The PHPT patients who died had also more often the severe form of PHPT: 55% of the patients with hypercalcaemic crises and 24% of the patients with cystic bone changes had died, whereas the respective percentage was 4% in the renal stone group. Four of the PHPT patients had died of uraemia, and, in addition, four patients had progressive renal damage. 18 PHPT patients had died of cardiac disease, four patients of a cerebrovascular attack and one patient of other vascular disease. There were eight cardiovascular deaths in the control group (p less than 0.01). There were no differences in other causes of death, such as malignant tumours, between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)