Impact of parathyroidectomy for primary hyperparathyroidism on quality of life: A case‐control study using Short Form Health Survey 36

Dulfer, R. R.; Geilvoet, Wanda; Morks, Annelien N.; Lieshout, Esther M.M. Van; Smit, Casper; Dijkum, Els J. M. Nieveen van; Hof, Klaas in’t; Dam, Frits van; Eijck, Casper H.J. van; Graaf, Peter W. de; Ginhoven, Tessa M. van

doi:10.1002/hed.24499

Cited by 17 publications

(16 citation statements)

References 24 publications

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“…Numerous observational studies have evaluated the effect of PTX in PHPT using the SF‐36 survey as well as other non‐disease‐specific questionnaires, suggesting improvement in HRQoL . An observational study by Rolighed et al HRQoL, assessed by SF‐36, were reduced in all 8 domains compared to healthy controls.…”

Section: Discussionmentioning

confidence: 99%

“…However, these nonspecific symptoms are difficult to quantify, and it is unclear to what extent these symptoms are related to PHPT and whether parathyroidectomy (PTX) relieves the symptoms. Most studies, so far, have evaluated health‐related quality of life (HRQoL) in PHPT using non‐disease‐specific questionnaire such as the Short Form‐36 (SF‐36) general health survey . Four randomized clinical trials (RCTs) assessed HRQoL in asymptomatic PHPT patients, including effect of parathyroidectomy (PTX).…”

Section: Introductionmentioning

confidence: 99%

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Health‐related quality of life improves 1 year after parathyroidectomy in primary hyperparathyroidism: A prospective cohort study

Ejlsmark-Svensson

Sikjær

Webb

et al. 2018

Clinical Endocrinology

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Objective: Impaired quality of life (QoL) in primary hyperparathyroidism (PHPT) is commonly present. Patients may complain about nonspecific neurocognitive symptoms which can be difficult to quantify. Two different disease-specific questionnaires have been developed, that is, the parathyroid assessment of symptoms score (PAS) and the primary hyperparathyroidism quality of life (PHPQoL). Using these two questionnaires, we assessed relationship between QoL and biochemical indices in PHPT and effects of parathyroidectomy (PTX). Design: A prospective cohort study.Methods: Patients with PHPT diagnosed from 2015 to 2017 were asked to answer the questionnaires before and 12 months after PTX. Biochemistry was obtained on both occasions. Results: A total of 104 PHPT patients answered PAS and PHPQoL questionnaires at baseline, with a median age of 64 years (73% females). PHPQoL score correlated inversely with ionized calcium and PTH at baseline (P ˂ 0.04). Total PAS and PHPQoL score did not differ between those with and without osteoporosis, renal calcifications and impaired renal function. Based on levels of ionized calcium, PHPQoL differed significantly between patients with mild-and moderate-severe hypercalcemia (P = 0.01). Fifty-three patients answered PAS and PHPQoL 12 months after PTX showing an improved QoL at follow-up (P all ˂ 0.02). Stratifying patients into groups based on levels of ionized calcium showed a significantly improved PHPQoL score in patients with mild (˂1.45 mmol/L) as well as moderate-severe hypercalcemia (≥1.45 mmol/L) at follow-up (P all ˂ 0.03).Conclusion: Quality of life improved 12 months after PTX in PHPT patients. Impaired QoL seems to be associated with the degree of hypercalcemia rather than organ manifestations attributable to PHPT. K E Y W O R D Scalcium, osteoporosis, parathyroid hormone, parathyroidectomy, primary hyperparathyroidism, quality of life, surveys and questionnaires | 185 EJLSMARK-SVENSSON Et AL.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life improves 1 year after parathyroidectomy in primary hyperparathyroidism: A prospective cohort study

Ejlsmark-Svensson

Sikjær

Webb

et al. 2018

Clinical Endocrinology

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“…This is especially noteworthy, considering that parathyroidectomy is a cost-effective cure associated with substantial improvement in symptoms. 9 , 12 , 31 , 32 , 33 …”

Section: Discussionmentioning

confidence: 99%

Analysis of Time to Diagnosis and Outcomes Among Adults With Primary Hyperparathyroidism

et al. 2022

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ImportanceDespite access to routine laboratory evaluation, primary hyperparathyroidism (PHP) remains underdiagnosed and undertreated.ObjectiveTo determine the consequences associated with missed diagnoses and prolonged time to diagnosis and treatment of PHP.Design, Setting, and ParticipantsThis is a retrospective cohort study of patients older than 40 years with 2 instances of hypercalcemia during 2010 to 2020 and 3 years of follow-up. Patients were recruited from 63 health care organizations in the TriNetX Research Network. Data analysis was performed from January 2010 to September 2020.ExposuresElevated serum calcium.Main Outcomes and MeasuresExisting symptoms and diagnoses associated with PHP (osteoporosis, fractures, urolithiasis, major depressive disorder, anxiety, hypertension, gastroesophageal reflux disease, malaise or fatigue, joint pain or myalgias, constipation, insomnia, polyuria, weakness, abdominal pain, headache, nausea, amnesia, and gallstones) compared in patients deemed high-risk and without a diagnosis and matched controls, and those who experienced times from documented hypercalcemia to diagnosis and diagnosis to treatment within or beyond 1 year.ResultsThere were 135 034 patients analyzed (96 554 women [72%]; 28 892 Black patients [21%] and 88 010 White patients [65%]; 3608 Hispanic patients [3%] and 98 279 non-Hispanic patients [73%]; mean [SD] age, 63 [10] years). Two groups without a documented diagnosis of PHP were identified as high risk: 20 176 patients (14.9%) with parathyroid hormone greater than or equal to 50 pg/mL and 24 905 patients (18.4%) with no parathyroid hormone level obtained or recorded explanation for hypercalcemia. High-risk patients experienced significantly increased rates of all associated symptoms and diagnoses compared with matched controls. Just 9.7% of those with hypercalcemia (13 136 patients) had a diagnosis of PHP. Compared with individuals who received a diagnosis within 1 year of hypercalcemia, those whose workup exceeded 1 year had significantly increased rates of major depressive disorder, anxiety, hypertension, gastroesophageal reflux disease, malaise or fatigue, joint pain or myalgias, polyuria, weakness, abdominal pain, and headache at 3 years. The rate of osteoporosis increased from 17.1% (628 patients) to 25.4% (935 patients) over the study period in the group with delayed diagnosis. Among those with a diagnosis, 5280 patients (40.2%) underwent parathyroidectomy. Surgery beyond 1 year of diagnosis was associated with significantly increased rates of osteoporosis and hypertension at 3 years after diagnosis compared with those treated within 1 year.Conclusions and RelevanceMany patients were at high risk for PHP without a documented diagnosis. Complications in these patients, as well as those who received a diagnosis after prolonged workup or time to treatment, resulted in patient harm. System-level interventions are necessary to ensure proper diagnosis and prompt treatment of PHP.

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“…In the literature, the effect of PTx on patients with PHPT has been evaluated using non-disease specific questionnaires such as the SF-36 and many other HRQoL questionnaires [19][20][21][22][23][24][25][26][27][28]. Rolighed et al [29] reported that HRQoL as assessed using the SF-36 was low in all 8 areas compared with a healthy control group.…”

Section: Discussionmentioning

confidence: 99%

The effect of parathyroidectomy on quality of life in primary hyperparathyroidism: evaluation with using sf-36 and phpqol questionnaire

Somuncu

Kara

2021

Endocr J

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Quality of life (QoL) typically improves with a parathyroidectomy (PTx) in cases of primary hyperparathyroidism (PHPT), but the effect of surgery on QoL is not yet fully understood. This study evaluated the impact of PTx on health-related QoL (HRQoL). Patients who underwent PTx for PHPT between January 2016 and December 2019 were asked to complete the 36-Item Short Form Health Survey (SF-36) and the Primary Hyperparathyroidism Quality of Life (PHPQoL) questionnaire before surgery and 1 year later. A 5-point Likert scale was used: negative responses received a lower score and positive responses scored high. Forty-one of 50 patients completed the questionnaires before and 12 months after the surgery. The median patient age was 64 years (min-max: 32-83 years). In the study group, 33 were female, and 8 were male. The SF-36 results indicated that significant improvements had been observed in all 8 domains a year after surgery, particularly in the physical functioning and role, general health, energy, and mental health scales. The PHPQoL scores also improved significantly after PTx (p < 0.05). The improvement in the physical and mental health components was 50% and 76%, respectively. In conclusion, this study demonstrated that PTx for PHPT improved QoL.

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Impact of parathyroidectomy for primary hyperparathyroidism on quality of life: A case‐control study using Short Form Health Survey 36

Cited by 17 publications

References 24 publications

Health‐related quality of life improves 1 year after parathyroidectomy in primary hyperparathyroidism: A prospective cohort study

Health‐related quality of life improves 1 year after parathyroidectomy in primary hyperparathyroidism: A prospective cohort study

Analysis of Time to Diagnosis and Outcomes Among Adults With Primary Hyperparathyroidism

The effect of parathyroidectomy on quality of life in primary hyperparathyroidism: evaluation with using sf-36 and phpqol questionnaire

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