Quality of life in patients with primary hyperparathyroidism before and at different time-points after surgery and factors associated with its improvement

BACKGROUND: For a comprehensive assessment of the effect of surgery in patients with primary hyperparathyroidism (PHPT) it sounds reasonable to evaluate quality of life (QoL) and symptoms in PHPT patients at long-term after parathyroidectomy (PTE). The purpose of this study was to study the quality of life of patients with PHPT before and at different times after PTE and to determine the factors associated with its improvement after surgery.
MATERIALS AND METHODS: During prospective observational study, patients filled out QoL questionnaires before, 3, 12, 24 months or more after surgery. Statistical analysis was performed using the Student’s t-test, the Mann-Whitney U-test, χ² criterion, the method of generalized estimating equations (GEE) and binary logistic regression. The differences were considered significant at the level of p<0.05.
RESULTS: The study included 82 patients (mean age 53,7 years, 95% female) with symptomatic (73%) and asymptomatic (27%) PHPT. Median follow–up duration was 20 (3–31) months. At 3 months after PTE, there was a significant increase in QoL for all scales of the generic SF-36 questionnaire, except for the pain scale, compared with their preoperative values, followed by the preservation of positive changes at long term after surgery (GEE, p<0.05). At the long term after surgery, scores for all SF-36 scales, except for role physical functioning (p=0.011), became similar with the ones in comparison group adjusted to patients by gender and age (n=60, 52.5±9.2 years, 95% were women). An independent predictor of significant improvement in QoL after PTE was the preoperative level of the mental component according to the PHPQoL questionnaire (p=0.001) — the lower its level, the greater the probability of significant improvement in QoL according to the total PHPQoL index after surgery (OR=0.924, p=0.004).
CONCLUSION. PTE is accompanied by significant improvement in QoL and regression of symptoms in patients with PHPT at long term follow-up after surgery. An independent predictor of significant QoL improvement after PTE is the preoperative level of the psychological component of QoL.

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