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Surgical Treatment of Hyperparathyroidism Improves Health-Related Quality of Life
David G. Sheldon, MD;
Faye T. Lee, RN;
Nancy J. Neil, PhD;
John A. Ryan, Jr, MD
Arch Surg. 2002;137:1022-1028.
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.
From the Section of General, Thoracic, and Vascular Surgery (Drs Sheldon and Ryan and Ms Lee) and Clinical Decision Support (Dr Neil), Virginia Mason Medical Center, Seattle, Wash. The authors have no commercial, proprietary, or financial interest in any of the products or companies mentioned in this article.
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