ECE2023 Eposter Presentations Calcium and Bone (99 abstracts)
Long-term outcomes of parathyroidectomy in patients with primary hyperparathyroidism from patient’s perspective
Dmitrii Buzanakov 1 , Roman Chernikov 1 , Sergey Efremov 1 , Inna Gladkova 1 , Tatiana Ionova 1 , Tatiana Nikitina 1 , Ilya Sleptsov 1 , Anna Zolotoukho 2 , Kirill Bubnov 2 , Vladimir Skvortsov 2 , Arina Vinogradova 2 & Vladimir Rusakov 1
1Saint Petersburg State University Hospital, Saint Petersburg, Russia; 2saint Petersburg State University, Saint Petersburg, Russia
Background: A parathyroidectomy (PTX) is the preferred standard treatment for patients with primary hyperparathyroidism (PHPT). the assessment of the surgery success from patient’s perspective is important to provide patient-centered care.
Aim: We aimed to evaluate QoL changes in PHPT patients during 2-years follow-up after PTX and to identify preoperative predictors of meaningful QoL improvement after surgery.
Materials and Methods: The single-center observational prospective study was carried out from September 2019 to October 2022. All the patients underwent routine PTХ. The objective success of surgery was confirmed by pathology confirmation of hyperfunctioning parathyroid tissue and postoperative normalization of Ca2+ and p-PTH. Patients filled out generic and specific QoL questionnaires–RAND SF-36 and PHPQoL before surgery, at 3, 12 and 24 months after PTX. To evaluate QoL changes after surgery GEE method with adjustment to gender, age, baseline QoL, clinical type of PHPT and level of hypercalcemia was applied. Binary logistic regression and χ2 were used to explore the association between preoperative variables and whether the patient had experienced meaningful QoL improvement in ≥9 points by PHPQoL total score.
Results: A total of 72 PHPT patients (median age–53.1±9.9 years, 94.4% females) who had objective surgery success were included in the analysis. From the total 70.8% patients had «symptomatic» PHPT, 29.2%–“asymptomatic” PHPT; mild hypercalcemia was detected in 65.3% patients, moderate or severe hypercalcemia–in 34.7% patients. During the entire follow-up period there was significant improvement in QoL after surgery by all scales of SF-36 questionnaire (P<0.01), excluding bodily pain, and by the PHPQoL total score (GEE, P<0.001) as compared with their preoperative values. Meaningful QoL improvement by PHPQoL total score (QoL response) was reported in 61.1% patients (QoL responders); the proportion of QoL responders was similar in patients with “symptomatic” and “asymptomatic” PHPT (60.8% vs 61.9%, p>0.05). Among preoperative variables, including type of PHPT (“symptomatic” or “asymptomatic”), Ca2+, p-PTH, disease duration, presence of comorbidities, patient’s age and education along with QoL parameters, only mental component of QoL by PHPQoL was significantly predicting of QoL response after surgery (OR=0.927, 95%CI=0.874-0.984, P=0.013).
Conclusions: Successful PTX was accompanied with remarkable QoL improvement for at least 24 months after surgery in both “symptomatic” and “asymptomatic” PHPT patients. Mental QoL component was the only one factor significantly predicting QoL response after surgery. This finding suggests that patients without overt clinical manifestation or prominent hypercalcemia, but with derangement of mental health may benefit from PTX.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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