title: Long-term results of parathyroidectomy for hypercalcemic crisis.
abstract: OBJECTIVE
  Hypercalcemic crisis is a rare complication of severe calcium intoxication usually caused by sporadic primary hyperparathyroidism that requires prompt diagnosis and definitive surgical treatment. Parathyroidectomy is essential for long-term successful treatment of hypercalcemic crisis.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Forty-three patients treated for hypercalcemic crisis during a 35-year period who had signs and symptoms of acute calcium intoxication and serum calcium levels of 15 mg/dL (3.75 mmol/L) or greater.
  
  
  METHODS
  Operative success, operative failure, and disease recurrence after surgery. Kaplan-Meier analysis was used to estimate long-term survival after parathyroidectomy.
  
  
  RESULTS
  Forty-two (98%) of 43 patients were eucalcemic after initial parathyroidectomy. There was 1 postoperative death. Of 27 patients with postoperative calcium data available for 6 months or longer, operative success was achieved in 26 (96%). There was 1 operative failure in a patient with multiglandular disease requiring reoperation. There were 3 recurrences (7%) at 7, 58, and 265 months. Overall median survival after parathyroidectomy was 11.7 years (95% confidence interval, 9.2-NE [not estimable]). The mean +/- SD serum calcium level of this group at a median follow-up of 4 years after surgery was 9.1 +/- 0.9 mg/dL (2.28 +/- 0.23 mmol/L).
  
  
  CONCLUSIONS
  Hypercalcemic crisis can be successfully treated by parathyroidectomy with continued normal parathyroid function and excellent long-term survival.
authors.affiliation: DeWitt Daughtry Family Department of Surgery, University of Miami/Jackson Memorial Veterans Affairs, Miami, FL 33131, USA.
authors.forename: John I
authors.initials: JI
authors.lastname: Lew
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Solorzano
authors.forename: George L
authors.initials: GL
authors.lastname: Irvin
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002118:Calcium