title: Parathyroidectomy improves symptomatology and quality of life in patients with secondary hyperparathyroidism.
abstract: BACKGROUND
  The parathyroidectomy assessment of symptoms (PAS) score was designed initially for primary hyperparathyroidism to provide a specific symptom assessment and was validated later in secondary and tertiary hyperparathyroidism. The aim of our study was to evaluate changes in the PAS scores and quality of life before and after parathyroidectomy for secondary hyperparathyroidism.
  
  
  METHODS
  This prospective study included 49 consecutive patients who underwent parathyroidectomy for secondary hyperparathyroidism. The PAS and Short Form (SF)-36 questionnaires were completed before parathyroidectomy and at 12 months postoperatively.
  
  
  RESULTS
  All 13 symptoms included in the PAS score improved significantly. The mean ± standard deviation PAS score decreased from 545 ± 263 to 284 ± 201 (P < .0001) after parathyroidectomy. Quality of life was enhanced in both physical (40.3 ± 17.1 to 59.0 ± 14.9; P < .0001) and mental (47.6 ± 17.1 to 63.7 ± 13.0; P < .0001) components. The PAS score was inversely correlated with the SF-36 global score preoperatively and postoperatively (r(2) = 0.48 and 0.25; P < .001). The change in PAS score also correlated with the change in SF-36 global score (r(2) = 0.29; P < .001). Multiple linear regression analysis showed that preoperative PAS score and bone mineral density T-score were predictors of the decrease in PAS score. Preoperative SF-36 global score and intact parathyroid hormone levels were predictors of the increment in SF-36 score.
  
  
  CONCLUSIONS
  The symptom burden of secondary hyperparathyroidism has a negative impact on a patient's quality of life. Parathyroidectomy is associated with a marked improvement in symptoms and quality of life.
authors.affiliation: Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Department of Pharmacology and Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shih-Ping
authors.initials: SP
authors.lastname: Cheng
authors.affiliation: Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Department of Pharmacology and Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jie-Jen
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
authors.forename: Tsang-Pai
authors.initials: TP
authors.lastname: Liu
authors.affiliation: Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Tsen-Long
authors.initials: TL
authors.lastname: Yang
authors.affiliation: Department of Nephrology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
authors.forename: Han-Hsiang
authors.initials: HH
authors.lastname: Chen
authors.affiliation: Department of Nephrology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Department of Pharmacology and Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Wu
authors.affiliation: Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan. Electronic address: surg.mmh@gmail.com.
authors.forename: Chien-Liang
authors.initials: CL
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D016896:Treatment Outcome; D055815:Young Adult