An Institutional experience with primary hyperparathyroidism in the elderly over two decades
2021; Elsevier BV; Volume: 222; Issue: 3 Linguagem: Inglês
10.1016/j.amjsurg.2021.01.027
ISSN1879-1883
AutoresKayla L O'Sullivan, Tina Yen, Kara Doffek, Sophie Dream, Ioanna G. Mazotas, Douglas B. Evans, Tracy Wang,
Tópico(s)Genetic Syndromes and Imprinting
ResumoAbstract 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.
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