PROSPECTIVE SURGICAL OUTCOME STUDY OF RELIEF OF SYMPTOMS FOLLOWING SURGERY IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM

Many of the symptoms experienced by patients with primary hyperparathy roidism (HPT) develop insidiously and have often been misinterpreted a s normal aging. The purpose of this study was to quantify HPT patients ' preoperative symptoms prospectively and study the impact of successf ul surgical intervention on these symptoms. Altogether 63 consecutive patients with primary HPT and 54 comparison patients with nontoxic thy roid disease were prospectively enrolled in the study. An outcome ques tionnaire documenting symptoms with a visual analog scale (VAS) was us ed. The questionnaire was filled out preoperatively and at 7 to 10 day s and 3 and 12 months postoperatively. At 1 year the questionnaire als o included a general health assessment and quality of life index. Demo graphic data and follow-up blood work was obtained. Descriptive statis tics, parametric comparisons (t-tests, ANOVA), and nonparametric compa risons (Mann-Whitney U-test) were calculated. The HPT group demonstrat ed a significant decrease in reported symptoms between the preoperativ ely assessment and 7 to 10 days after operation (p < 0.001). There wer e no further statistically significant decreases in the HT group's sym ptoms at 3 and 12 months, but there was a trend for these symptoms to decrease over time. HPT patients perceived a 60% increase in their gen eral health at 1 year; the comparison group perceived no increase. The re was no significant change in the symptoms reported by the compariso n group between each of the study intervals. Surgical intervention on HPT patients significantly reduces preoperative symptoms, and this red uction is most marked within the first 10 days after surgery.