Surgical Treatment of Hyperparathyroidism Improves Health-Related Quality of Life

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Abstract
Hypothesis The surgical treatment of primary hyperparathyroidism results in an improved health-related quality of life. Design Prospective cohort analysis of consecutive patients with primary hyperparathyroidism analyzed preoperatively and 1 year postoperatively. Setting Academic multispecialty referral clinic. Patients We prospectively evaluated 74 consecutive patients who underwent parathyroid exploration for primary hyperparathyroidism during a 15-month period. Interventions The Medical Outcomes Study Short-Form Health Survey (SF-36) was administered before consultation with a surgeon. Patients were categorized based on reason for referral as either asymptomatic (group 1; n = 43) or symptomatic (group 2; n = 29). All patients underwent parathyroid exploration and normalization of calcium levels postoperatively. The SF-36 was then re-administered after 1 year. Main Outcome Measures Statistical analysis of preoperative and postoperative SF-36 scores, and comparisons with national norms. Results The SF-36 was completed preoperatively and 1 year postoperatively by 72 (97%) of 74 patients. When the results were compared with published national norms, the preoperative population was significantly impaired in 5 of 8 domains, whereas the postoperative one had improved and was nearly indistinguishable from the norm. In 7 of 8 domains, the postoperative scores were significantly improved compared with preoperative scores. Group 1 patients showed significant preoperative impairment in 3 domains and significantly improved in 2, whereas group 2 patients showed significant impairment and improvement in 7 domains. Conclusion The surgical treatment of primary hyperparathyroidism is associated with durable, statistically significant improvements in health-related quality of life.