World Journal of Surgery

, Volume 26, Issue 8, pp 942–949 | Cite as

Patient-based Surgical Outcome Tool Demonstrating Alleviation of Symptoms following Parathyroidectomy in Patients with Primary Hyperparathyroidism

  • Janice L. Pasieka
  • Louise L. Parsons
  • Michael J. Demeure
  • Stuart Wilson
  • Peter Malycha
  • Jean Jones
  • Beth Krzywda

This study assessed the impact of parathyroidectomy on the preoperative symptoms of patients with primary hyperparathyroidism (1° HPT) using a surgical outcome tool designed specifically for HPT. The multicenter nature of this study allowed us to validate further this disease-specific outcome tool. 1° HPT patients from Canada, the United States, and Australia filled out the questionnaire preoperatively and postoperatively on day 7 and at 3 and 12 months. The symptoms recorded by the patients were expressed as parathyroidectomy assessment of symptoms (PAS) scores: the higher the score, the more symptomatic is the patient. Quality of Life (QOL) and self-rated health uni-scales were included. Altogether, 203 patients with 1° HPT were enrolled; 27 from center A, 54 from center B, and 122 from center C; 58 nontoxic thyroid patients were enrolled for comparison. The comparison group had no significant change in their PAS scores throughout the study (scores 184, 215, 156, 186). All three centers demonstrated a significant reduction in symptoms following surgery. The median preoperative PAS score from center B patients was 282. Following surgery, PAS scores decreased significantly: 136, 58, 0 (p <0.05). Center C patients had a median preoperative PAS score of 344, decreasing postoperatively to 228 (p <0.05) and continuing to decrease to 190, then 180. Center A also demonstrated a significant reduction in symptoms at 3 months, from 510 preoperatively to 209 (p <0.001). Both QOL and self-rated health improved in the HPT patients, whereas no change was found in the comparison group following surgery. PAS scores are a reliable, disease-specific measure of symptoms seen with HPT. Parathyroidectomy significantly reduces these preoperative symptoms, and this change translated into an improved health-related QOL for the patients.

Keywords

Comparison Group Hyperparathyroidism Surgical Outcome Primary Hyperparathyroidism Preoperative Symptom 
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.

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Copyright information

© 2002 by the Société Internationale de Chiru rgie

Authors and Affiliations

  • Janice L. Pasieka
    • 1
  • Louise L. Parsons
    • 1
  • Michael J. Demeure
    • 2
  • Stuart Wilson
    • 2
  • Peter Malycha
    • 3
  • Jean Jones
    • 1
  • Beth Krzywda
    • 2
  1. 1.Department of Surgery, Division of General Surgery, University of Calgary, Foothills Medical Center, 1403 29th Street NW, Calgary, Alberta, Canada T2N 2T9CANADA
  2. 2.Department of Surgery, Division of General Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, Wisconsin 53226, USAUSA
  3. 3.Department of Surgery, Division of General Surgery, University of Adelaide, 333 South Terrace, Adelaide, South Australia 5000, AustraliaAUSTRALIA

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