Pasieka’s Parathyroid Symptoms Scores Correlate with SF-36 Scores in Patients Undergoing Surgery for Primary Hyperparathyroidism
- 326 Downloads
Parathyroidectomy for primary hyperparathyroidism (PHPT) is expected to trigger an improvement in the quality of life. This has been demonstrated previously by using the SF-36 questionnaire, whose interpretation is difficult in routine clinical practice. As an alternative, the 13-item questionnaire developed by Pasieka et al. can be used to assess the severity of symptoms on a visual analogue from which a parathyroid assessment of symptoms score (PAS) can be calculated. The purpose of this study was to correlate results of these two assessment tools.
Prospective case-series study recruiting consecutive unselected patients who underwent successful parathyroidectomy for PHPT. SF-36(v2) and Pasieka’s questionnaires were collected before parathyroidectomy and at 3, 6, and 12 months postoperatively.
Between November 2005 and December 2006, 101 patients were diagnosed with PHPT (30 men; aged 18–89 years). Preoperative PAS ranged 0–1040 and did not correlate with the severity of hypercalcemia (2.91 ± 0.25; range, 2.56–3.4 mmol/l). Scores from the SF-36 questionnaire were under the 50th percentile for the normal population in three domains (vitality, emotional role, and physical role). Minimally invasive parathyroidectomy was performed in 69 patients and bilateral cervical exploration in 32 patients. All were found to have a single parathyroid adenoma and were normocalcemic at 3–12 months after parathyroidectomy.
At follow-up, there was a significant reduction of PAS from 460 ± 257 preoperatively to 254 ± 234 at 3 months postoperatively (n = 72), to 245 ± 215 at 6 months (n = 50), and 249 ± 212 at 12 months (n = 63) (p < 0.05, Student’s t-test). There was a significant and persistent improvement in five domains of SF-36 questionnaire: bodily pain, general health, vitality, social functioning and mental health. Overall analysis of 244 assessments using both questionnaires demonstrated a negative correlation between increasing PAS and decreasing mental component scores and physical component scores of the SF-36 assessment (r2 = 0.372 and 0.301, respectively).
Pasieka’s parathyroid assessment of symptom scores (PAS) correlate with SF-36 questionnaire scores. Because PAS allows easier and faster analysis, we advocate that Pasieka’s questionnaire should be integrated into the assessment of patients with PHPT as a reliable tool to identify symptomatic changes that correlate with improved quality of life.
KeywordsPrimary Hyperparathyroidism Parathyroid Adenoma Mental Component Score Physical Component Score Postoperative Improvement
- 3.Caillard C, Sebag F, Mathonnet M, Gibelin H, Brunaud L, Loudot C, Kraimps JL, Hamy A, Bresler L, Charbonnel B, Leborgne J, Henry JF, Nguyen JM, Mirallie E (2007) Prospective evaluation of quality of life (SF-36v2) and nonspecific symptoms before and after cure of primary hyperparathyroidism (1-year follow-up). Surgery 141:153–159PubMedCrossRefGoogle Scholar
- 4.Ambrogini E, Cetani F, Cianferotti L, Vignali E, Banti C, Viccica G, Oppo A, Miccoli P, Berti P, Bilezikian JP, Pinchera A, Marcocci C (2007) Surgery or surveillance for mild asymptomatic primary hyperparathyroidism: a prospective, randomized clinical trial. J Clin Endocrinol Metab 92(8):3114–3121PubMedCrossRefGoogle Scholar
- 5.Bollerslev J, Jansson S, Mollerup CL, Nordenstrom J, Lundgren E, Torring O, Varhaug JE, Baranowski M, Aanderud S, Franco C, Freyschuss B, Isaksen GA, Ueland T, Rosen T (2007) Medical observation compared to parathyroidectomy for asymptomatic primary hyperparathyroidism: a prospective, randomized trial. J Clin Endocrinol Metab 92:1687–1692PubMedCrossRefGoogle Scholar
- 9.Mihai R, Sadler G, Wass JAH (2008) Asymptomatic primary hyperparathyroidism – need for multicentre studies. Clinical Endocrinol 68:155–164Google Scholar
- 14.Bilezikian JP, Potts JT Jr, Fuleihan Gel H, Kleerekoper M, Neer R, Peacock M, Rastad J, Silverberg SJ, Udelsman R, Wells SA Jr (2002) Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Bone Miner Res 17(Suppl 2):N2–11PubMedGoogle Scholar