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World Journal of Surgery

, Volume 14, Issue 6, pp 829–835 | Cite as

Premature death in patients operated on for primary hyperparathyroidism

  • Gunilla Hedbäck
  • Lars-Erik Tisell
  • Bengt-åke Bengtsson
  • Ingmar Hedman
  • Anders Oden
Original Scientific Reports

Abstract

To investigate long-term survival after operation for primary hyperparathyroidism, a follow-up study was performed on 896 consecutive patients in whom this diagnosis had been clinically and microscopically verified. These patients were operated on in the years 1953–1982. Their mean age at operation was 57.3 years [standard deviation (SD) 13.1], overall cure rate was 97.0%, and postoperative mortality was 0.89%. Follow-up was 99.8% complete by the end of 1986. Mean follow-up time was 12.9 years (SD: 6.1). Two-hundred ninety-four patients were deceased, which was 118 more than in a control group (p<0.001). The latter was based on Swedish population statistics, matched for age, sex, and calendar year. Each year, the control group was the same size as the hyperparathyroid population. The risk of premature death remained increased (p<0.001) even after exclusion of poor-risk patients having their hyperparathyroidism diagnosed when being treated or followed because of other serious diseases. The main causes of premature death for the hyperparathyroid patients were cardiovascular and malignant diseases. Both occurred more often than in the control group (p<0.001). The results demonstrate that primary hyperparathyroidism causes damage that is not reversed by surgery.

Keywords

Hyperparathyroidism Malignant Disease Population Statistic Premature Death Primary Hyperparathyroidism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Pour évaluer la survie à long terme après opération pour hyperparathyroÏdie primaire, le devenir de 896 patients chez lesquels ce diagnostic avait été clinquement posé et vérifié histologiquement a été analysé. Ces patients ont été opérés entre 1953 et 1982. L'âge moyen au moment de l'intervention était de â 57.3 ans (ET: 13.1), le taux global de cure était de 97.0%, la mortalité post-opératoire était de 0.89%. Le suivi était complet à 99.8% à la fin de l'année 1986. Le suivi moyen était de 12.9 ans (ET: 6.1). Deux cent quatre vingt quatorze patients sont morts, 118 de plus que dans le groupe contrôle (p<0.001), basé sur les statistiques suédoises d'une population composée de sujets comparables du point de vue âge, sexe, et année de mort. Le groupe de contrôle était de la mÊme taille pour chaque année que pour la population hyperparathyroÏde. Le risque de mort précoce chez les patients hyperparathyroÏdes était augmenté (p<0.001) mÊme après exclusion des patients à haut risque dont l'hyperparathyroÏdie avait été diagnostiquée pendant le traitement d'une autre maladie grave. Les principales causes de mort précoce chez le patient hyperparathyroÏdien étaient soit une maladie cardiovasculaire, soit une maladie maligne. Les deux étaient plus fréquentes que dans le groupe de contrôle (p<0.001). Ces résultats démontrent que l'hyperparathyrodie est responsable de lésions qui ne sont pas réversibles après cure de l'hyperparathyroÏdie.

Resumen

Con el fin de investigar la sobrevida a largo plazo después del tratamiento quirÚrgico del hiperparatiroidismo primario, se realizó un estudio de seguimiento en 896 pacientes consecutivos en los cuales se comprobó el diagnóstico por la clínica y por métodos microscópicos. Estos pacientes fueron operados en el período 1953–1982. Le edad promedio en el momento de la operación fue 57.3 años (DE: 13.1), la tasa global de curación 97.0%, y la mortalidad postoperatoria 0.89%. El seguimiento fue completo en el 99.8% de los casos hasta el final de 1986. El promedio de tiempo de seguimiento fue de 12.9 años (DE: 6.1); 294 pacientes murieron, cifra que fue 118 personas, mayor que en el grupo control (p<0.001), el cual se basó en estadísticas suecas para una población similar en cuanto a edad, sexo, y años calendario.

El grupo control fue cada año del mismo volumen que el de la población hiperparatiroidea. El riesgo de muerte prematura se mantuvo aumentado (p<0.001) aun después de excluir los pacientes de alto riesgo en los cuales se diagnosticó el hiperparatiroidismo mientras estaban bajo tratamiento por otras enfermedades serias. Las causas de muerte prematura principal en los pacientes hiperparatiroideos fueron las enfermedades cardiovasculares y las neoplasias malignas; ambas se presentaron con mayor frecuencia que en el grupo control (p<0.001). Los resultados demuestran que el hiperparatiroidismo primario causa lesiones que no revierten con la cirugía.

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Copyright information

© Société Internationale de Chirurgie 1990

Authors and Affiliations

  • Gunilla Hedbäck
    • 1
    • 2
  • Lars-Erik Tisell
    • 1
    • 2
  • Bengt-åke Bengtsson
    • 1
    • 2
  • Ingmar Hedman
    • 1
    • 2
  • Anders Oden
    • 1
    • 2
  1. 1.Departments of Surgery and MedicineSahlgren's HospitalSweden
  2. 2.Department of Mathematics and StatisticsUniversity of GöteborgGöteborgSweden

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