Impact of parathyroidectomy on quality of life in primary hyperparathyroidism

Patients with primary hyperparathyroidism (PHPT) frequently report symptoms that are associated with the disease and impact on their quality of life (QoL). While parathyroidectomy corrects calcium and PTH levels, its impact on improving patients' QoL is not clear. In this single centre prospective study, we aimed to assess the impact of a parathyroidectomy on PHPT patients' pre and post parathyroidectomy QoL over a period of three years and nine months. PHPT patients, undergoing parathyroidectomy, voluntarily completed a modified Pasieka Parathyroidectomy Assessment Score (PAS), a tool correlating 13 PHPT symptoms to QoL. Sixty patients with PHPT (mean age 64 years, female to male 4:1) were included in the study. Pre parathyroidectomy, the most common symptoms were: feeling tired easily (n = 58); being forgetful (n = 51); pain in the joints (n = 49); feeling irritable (n = 48) bone pain (n = 45); feeling weak (n = 45); mood swings (n = 42); and being thirsty (n = 42). Parathyroidectomy reduced severity of mean total PAS by 44%, improving from 509 to 284 (p < 0.01). A total of 77% (n = 46) of patients experienced some improvement of PAS. The five most severe symptoms (highest reported individual PAS) showed a significant reduction post parathyroidectomy (p < 0.01): feeling tired easily (mean PAS 65 vs 38); pain in the joints (52 vs 31); being thirsty (46 vs 22); being forgetful (45 vs 28); and bone pain (45 vs 27). Patients with PHPT demonstrated impaired QoL as evidenced by the PAS, and assessing this is valuable in treatment planning. Parathyroidectomy impacts the symptoms that most affect QoL and significantly improves overall QoL in these patients.