Faculty Collaboration Database

An Institutional experience with primary hyperparathyroidism in the elderly over two decades. Am J Surg 2021 Sep;222(3):549-553

Date

02/09/2021

Pubmed ID

33551115

DOI

10.1016/j.amjsurg.2021.01.027

Scopus ID

2-s2.0-85100630649 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

BACKGROUND: Parathyroidectomy is the only curative treatment for primary hyperparathyroidism (pHPT) and is associated with low morbidity. This study examined the severity of disease and outcomes of parathyroidectomy based on patient age at a high-volume institution.

METHODS: This is a retrospective review of sporadic pHPT patients who underwent initial parathyroidectomy. To study disease severity over time, patients were divided into timeframes: 1999-2007, 2007-2012, and 2013-2018. Elderly was defined as age ≥75 years.

RESULTS: Over time, the elderly had progressively lower preoperative calcium (11.0, 10.7, 10.7; p = 0.05) and PTH (150.4, 111.9, 107.9; p < 0.001) levels. By age, there was no difference in preoperative calcium (10.8, 10.9; p = 0.91) or in rates of recurrent laryngeal nerve injury, hypoparathyroidism, or persistent/recurrent pHPT.

CONCLUSIONS: Over the 3 time periods of the study, elderly patients had progressively lower calcium and PTH levels. There was no difference in endocrine-specific complications between the age groups, suggesting that parathyroidectomy in the elderly is safe and therefore, age-associated morbidity should not preclude parathyroidectomy.

Author List

O'Sullivan K, Yen TWF, Doffek K, Dream S, Mazotas I, Evans DB, Wang TS

Authors

Sophie Y. Dream MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin
Tracy S. Wang MD, MPH Professor in the Surgery department at Medical College of Wisconsin
Tina W F Yen MD, MS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Calcium
Female
Hospitals, High-Volume
Humans
Hyperparathyroidism, Primary
Male
Parathyroid Hormone
Parathyroidectomy
Postoperative Complications
Preoperative Period
Recurrent Laryngeal Nerve Injuries
Retrospective Studies
Severity of Illness Index
Time Factors
Treatment Outcome
Vitamin D