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The impact of age on quality of life and frailty outcomes after parathyroidectomy in patients with primary hyperparathyroidism

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Abstract

Objective

Parathyroidectomy (PTx) improves quality of life (QoL) in patients with primary hyperparathyroidism (PHPT). Whether this effect is modified according to the patients’ age is unknown. The aim of this study was to evaluate the impact of age on the effect of PTx on QoL and frailty in patients with PHPT, six months post-PTx.

Methods

This was a prospective cohort study, including patients with PHPT, admitted from January 2016 to December 2019, divided into two categories: younger (≤ 65 years old) and older (> 65 years old). QoL was assessed with the Pasieka questionnaire (PAS-Q) two days pre- and six months post-operatively. Frailty was also assessed at the same time intervals, with the Frailty Index (FI).

Results

One hundred and thirty-four patients (younger group: 96 patients, mean age 50.4 ± 9.8 years; older group: 38 patients, mean age 72.1 ± 4.9 years) were included. PTx resulted in a significant reduction in PAS-Q score in both groups. Notably, a greater reduction in “mood swings”, “irritability”, “itchy skin” and “feeling thirsty” PAS-Q domains was observed in the younger group. In contrast, a greater decrease in “bone pain”, “tiredness”, “weakness”, “joint pain”, “getting off chair” and “headaches” items was observed in the older group. Moreover, PTx led to a decrease in FI only in this group.

Conclusions

PTx leads to an improvement in QoL both in older (> 65 years) and younger (≤ 65 years) patients with PHPT, attributed to a differential effect on PAS-Q items. Frailty improves only in the older group.

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References

  1. Rao SD (2018) Epidemiology of parathyroid disorders. Best Pract Res Clin Endocrinol Metab 32:773–780

    Article  Google Scholar 

  2. Yu N, Donnan PT, Murphy MJ, Leese GP (2009) Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol (Oxf) 71:485–493

    Article  Google Scholar 

  3. Coker LH, Rorie K, Cantley L, Kirkland K, Stump D, Burbank N, Tembreull T, Williamson J, Perrier N (2005) Primary hyperparathyroidism, cognition, and health-related quality of life. Ann Surg 242:642–650

    Article  Google Scholar 

  4. Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C, Potts JT Jr (2014) Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab 99:3561–3569

    Article  CAS  Google Scholar 

  5. Wilhelm SM, Wang TS, Ruan DT et al (2016) The American association of endocrine surgeons guidelines for definitive management of primary hyperparathyroidism. JAMA Surg 151:959–968

    Article  Google Scholar 

  6. Wu B, Haigh PI, Hwang R, Ituarte PH, Liu IL, Hahn TJ, Yeh MW (2010) Underutilization of parathyroidectomy in elderly patients with primary hyperparathyroidism. J Clin Endocrinol Metab 95:4324–4330

    Article  CAS  Google Scholar 

  7. Anagnostis P, Vaitsi K, Veneti S, Potoupni V, Kenanidis E, Tsiridis E, Papavramidis TS, Goulis DG (2021) Efficacy of parathyroidectomy compared with active surveillance in patients with mild asymptomatic primary hyperparathyroidism: a systematic review and meta-analysis of randomized-controlled studies. J Endocrinol Invest 44:1127–1137

    Article  CAS  Google Scholar 

  8. Ware JE, Snow KK, Kosinksi M et al (1993) SF-36 health survey: manual and interpretation guide. The Health Institute, New England Medical Center, Boston, MA

    Google Scholar 

  9. Pasieka JL, Parsons LL (1998) Prospective surgical outcome study of relief of symptoms following surgery in patients with primary hyperparathyroidism. World J Surg 22:513–518 (discussion 518-519)

    Article  CAS  Google Scholar 

  10. Mihai R, Sadler GP (2008) Pasieka’s parathyroid symptoms scores correlate with SF-36 scores in patients undergoing surgery for primary hyperparathyroidism. World J Surg 32:807–814

    Article  Google Scholar 

  11. Liu M, Sum M, Cong E et al (2020) Cognition and cerebrovascular function in primary hyperparathyroidism before and after parathyroidectomy. J Endocrinol Invest 43:369–379

    Article  CAS  Google Scholar 

  12. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A (2005) A global clinical measure of fitness and frailty in elderly people. CMAJ 173:489–495

    Article  Google Scholar 

  13. Voss L, Nobrega M, Bandeira L, Griz L, Rocha-Filho PAS, Bandeira F (2020) Impaired physical function and evaluation of quality of life in normocalcemic and hypercalcemic primary hyperparathyroidism. Bone 141:115583

    Article  CAS  Google Scholar 

  14. Ejlsmark-Svensson H, Sikjaer T, Webb SM, Rejnmark L, Rolighed L (2019) Health-related quality of life improves 1 year after parathyroidectomy in primary hyperparathyroidism: a prospective cohort study. Clin Endocrinol (Oxf) 90:184–191

    Article  Google Scholar 

  15. Quiros RM, Alef MJ, Wilhelm SM, Djuricin G, Loviscek K, Prinz RA (2003) Health-related quality of life in hyperparathyroidism measurably improves after parathyroidectomy. Surgery 134:675–681 (discussion 681-673)

    Article  CAS  Google Scholar 

  16. Ryhanen EM, Heiskanen I, Sintonen H, Valimaki MJ, Roine RP, Schalin-Jantti C (2015) Health-related quality of life is impaired in primary hyperparathyroidism and significantly improves after surgery: a prospective study using the 15D instrument. Endocr Connect 4:179–186

    Article  CAS  Google Scholar 

  17. Dombrowsky A, Borg B, Xie R, Kirklin JK, Chen H, Balentine CJ (2018) Why is hyperparathyroidism underdiagnosed and undertreated in older adults? Clin Med Insights Endocrinol Diabetes 11:1179551418815916

    Article  Google Scholar 

  18. Tzikos G, Chorti A, Evangelos S et al (2021) Quality of life in patients with asymptomatic primary hyperparathyroidism after parathyroidectomy: a 3-year longitudinal study. Endocr Pract. https://doi.org/10.1016/j.eprac.2021.01.003

    Article  PubMed  Google Scholar 

  19. Vadhwana B, Currow C, Bowers D, Groot-Wassink T (2021) Impact on quality of life after parathyroidectomy for asymptomatic primary hyperparathyroidism. J Surg Res 261:139–145

    Article  Google Scholar 

  20. Amstrup AK, Rejnmark L, Mosekilde L (2011) Patients with surgically cured primary hyperparathyroidism have a reduced quality of life compared with population-based healthy sex-, age-, and season-matched controls. Eur J Endocrinol 165:753–760

    Article  CAS  Google Scholar 

  21. Blanchard C, Mathonnet M, Sebag F et al (2014) Quality of life is modestly improved in older patients with mild primary hyperparathyroidism postoperatively: results of a prospective multicenter study. Ann Surg Oncol 21:3534–3540

    Article  Google Scholar 

  22. Egan KR, Adler JT, Olson JE, Chen H (2007) Parathyroidectomy for primary hyperparathyroidism in octogenarians and nonagenarians: a risk-benefit analysis. J Surg Res 140:194–198

    Article  Google Scholar 

  23. Polistena A, Lucchini R, Monacelli M, Triola R, Avenia S, Barillaro I, Johnson LB, Sanguinetti A, Avenia N (2017) Current indications for surgical treatment of primary hyperparathyroidism in the elderly. Am Surg 83:296–302

    Article  Google Scholar 

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Correspondence to P. Anagnostis.

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Papavramidis, T.S., Anagnostis, P., Pliakos, I. et al. The impact of age on quality of life and frailty outcomes after parathyroidectomy in patients with primary hyperparathyroidism. J Endocrinol Invest 45, 797–802 (2022). https://doi.org/10.1007/s40618-021-01710-5

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  • DOI: https://doi.org/10.1007/s40618-021-01710-5

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