title: The extent of improvement of health-related quality of life as assessed by the SF36 and Paseika scales after parathyroidectomy in patients with primary hyperparathyroidism--a systematic review and meta-analysis.
abstract: BACKGROUND
  Previous studies have shown that parathyroidectomy for primary hyperparathyroidism (PHPT) improve the function and quality of life of patients. The aim of this systematic review and meta-analysis is to determine the health-related quality of life outcomes among those having surgical management for PHPT.
  
  
  METHODS
  Several databases were searched (MEDLINE, EMBASE, PubMed, Current Contents) for studies in which health-related quality of life was measured by reliable and validated instruments (SF-36 and Paseika Questionnaire) before and after parathyroidectomy for patients with primary hyperparathyroidism (PHPT). For the SF-36, score differences greater than 5 points indicate clinically relevant changes.
  
  
  RESULTS
  There were six studies with quality of life data. The SF-36 data was derived from 238 patients, with a mean age of 59 years and 71% were females. The range of follow up after surgery was 6 months to one year. The pre- and post-parathyroidectomy SF-36 quality of life scale scores were vitality (44 vs. 60, p<0.001), physical functioning (51 vs. 69, p<0.001), bodily pain (50 vs. 65, p<0.001), general health (54 vs. 64, p<0.001), role physical (34 vs. 52, p<0.001), role emotional (43 vs. 59, p<0.001), role social (60 vs. 74, p<0.001), and mental health (55 vs. 71, p<0.001). The Paseika data was derived from 203 patients, with a mean age of 54 years and 67% were females. The pre- and post-parathyroidectomy Paseika scores were feeling tired (51 vs. 19, p<0.001), feeling thirsty (29 vs. 12, p<0.001), mood swings (33 vs. 12, p<0.001), joint pains (32 vs. 14, p<0.001), irritability (31 vs. 10, p<0.001), feeling blue (31 vs. 14, p<0.001), feeling weak (37 vs. 15, p<0.001), itchy (17 vs. 7, p<0.001), forgetful (27 vs. 16, p<0.001), headache (18 vs. 5, p<0.001), abdominal pain (19 vs. 8, p<0.001), bone pain (38 vs. 17, p<0.001), ability to move off chair (27 vs. 11, p<0.001).
  
  
  CONCLUSIONS
  Parathyroidectomy significantly improves the short to medium-term health-related quality of life of patients suffering from primary hyperparathyroidism.
authors.affiliation: The University of Sydney, Australia.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Brito
authors.affiliation: The University of Sydney, Australia.
authors.forename: Senarath
authors.initials: S
authors.lastname: Edirimanne
authors.affiliation: The University of Sydney, Australia. Electronic address: eslickg@med.usyd.edu.au.
authors.forename: Guy D
authors.initials: GD
authors.lastname: Eslick
mesh_terms: D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000534:rehabilitation / Q000601:surgery*; D008875:Middle Aged; D016105:Parathyroidectomy / Q000379:methods / Q000534:rehabilitation*; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Health-related quality of life; Meta-analysis; Parathyroidectomy; Primary hyperparathyroidism