title: Patient-based surgical outcome tool demonstrating alleviation of symptoms following parathyroidectomy in patients with primary hyperparathyroidism.
abstract: This study assessed the impact of parathyroidectomy on the preoperative symptoms of patients with primary hyperparathyroidism (1 degrees 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 degrees 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 degrees 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.
authors.affiliation: Department of Surgery, Division of General Surgery, University of Calgary, Foothills Medical Center, 1403 29th Street NW, Calgary, Alberta, Canada T2N 2T9. janice.pasieka@calgaryhealthregion.ca
authors.forename: Janice L
authors.initials: JL
authors.lastname: Pasieka
authors.forename: Louise L
authors.initials: LL
authors.lastname: Parsons
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Demeure
authors.forename: Stuart
authors.initials: S
authors.lastname: Wilson
authors.forename: Peter
authors.initials: P
authors.lastname: Malycha
authors.forename: Jean
authors.initials: J
authors.lastname: Jones
authors.forename: Beth
authors.initials: B
authors.lastname: Krzywda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D006961:Hyperparathyroidism / Q000523:psychology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D016105:Parathyroidectomy; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome