Patient-based surgical outcome tool demonstrating alleviation of symptoms following parathyroidectomy in patients with primary hyperparathyroidism |
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Authors: | Pasieka Janice L Parsons Louise L Demeure Michael J Wilson Stuart Malycha Peter Jones Jean Krzywda Beth |
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Institution: | (1) Department of Surgery, Division of General Surgery, University of Calgary, Foothills Medical Center, 1403 29th Street NW, Calgary, Alberta, Canada T2N 2T9, CANADA;(2) Department of Surgery, Division of General Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, Wisconsin 53226, USA, USA;(3) Department of Surgery, Division of General Surgery, University of Adelaide, 333 South Terrace, Adelaide, South Australia 5000, Australia, AUSTRALIA |
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Abstract: | 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. |
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Keywords: | |
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