Surgical outcomes researchHealth status improvement after surgical correction of primary hyperparathyroidism in patients with high and low preoperative calcium levels☆,☆☆
Section snippets
Patients and methods
Starting in March 1994, a convenience sample of patients with primary HPT seen by the endocrine surgery division at University of Michigan Health Systems was asked to complete the SF-36 questionnaire and to provide additional demographic and condition-specific information for study. The plan for obtaining informed consent and for patient participation in the study was approved by the University of Michigan Medical School Institutional Review Board. Patients agreeing to participate were asked by
Results
One hundred fifty-five patients with primary hyperparathyroidism who entered the study between 1994 and 1998 had complete baseline data including preoperative calcium levels. Eighty-six had serum calcium levels <10.9 mg/dL (normal <10.5 mg/dL). These were designated as having “low” calcium levels. Sixty-nine patients had serum calcium levels equal to or greater than 10.9 mg/dL (range 10.9 to 13.4 mg/dL) and were designated as having “high” preoperative calcium levels.
One hundred four patients
Discussion
The major finding of this study is that, with use of the SF-36 Health Survey and condition-specific questionnaires, patients with primary HPT reported profound deficits in functional health status and well-being. These deficits spanned both physical and mental function and were quantitatively and qualitatively similar regardless of whether the level of serum calcium was above or below 10.9 mg/dL.
After surgical correction of primary HPT, patients reported that functional health status improved
Conclusions
The SF-36 Health Survey is highly sensitive to the multidimensional changes in functional health status in patients with primary HPT. Our data suggest that patients with both high and low calcium levels have equivalent, significant functional health status deficits. Both groups of patients improve dramatically after surgical correction of primary HPT, but patients with lower levels of serum calcium preoperatively report less pain 6 months after operation and may achieve better health status
Acknowledgements
We thank Melissa Peterson, RN, MS, and Jane Wilson Coon, RN, DNSc, for their support and assistance in the early phases of this work.
References (24)
- et al.
Surgical correction of primary hyperparathyroidism improves quality of life
Surgery
(1998) - et al.
Primary hyperparathyroidism
Lancet
(1997) Indications for surgery in patients with minimally symptomatic primary hypeparathyroidism
Surg Clin North Am
(1995)- et al.
Psychologic symptoms before and after parathyroid surgery
Am J Med
(1994) - et al.
Psychiatric symptoms and cerebrospinal fluid monoamine metabolites in primary hyperparathyroidism
Biol Psychiatry
(1988) - et al.
Primary hyperthyroidism: incidence of cardiac abnormalities and partial reversibility after successful parathyroidectomy
Am J Med
(1993) - et al.
Time course of regression of left ventricular hyupertrophy after successful parathyroidectomy
Surgery
(1997) - et al.
Parathyroid adenoma weight and the risk of death after treatment for primary hyperparathyroidism
Surgery
(1995) - et al.
Assessment of patient outcomes after operation for primary hyperparathyroidism
Surgery
(1996) - et al.
Core outcome measures for inguinal hernia repair
J Am Coll Surg
(1997)
Proceedings of the NIH consensus development conference on diagnosis and management of asymptomatic primary hyperparathyroidism
J Bone Miner Res
The MOS 36-item short-form health survey (SF-36), I: conceptual framework and item selection
Med Care
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Supported by the University of Michigan Health System Small Grant Program.
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Reprint requests: Richard E. Burney, MD, TC2922 University Hospital, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0331.