Age-Related Differences in Surgical and Biochemical Outcomes Following Parathyroidectomy for Primary...

Area of Science:

• Endocrinology
• Surgical Oncology
• Geriatric Medicine

Background:

• Primary hyperparathyroidism (PHPT) incidence rises in older adults.
• Parathyroidectomy is often deferred in elderly patients due to comorbidities and limited age-specific outcome data.
• This study investigates age-related differences in PHPT surgical outcomes.

Purpose of the Study:

• To evaluate age-related differences in clinical characteristics, perioperative outcomes, complications, and biochemical responses after parathyroidectomy for PHPT.
• To assess the safety and efficacy of parathyroidectomy across different age groups.

Main Methods:

• Retrospective analysis of 596 patients undergoing parathyroidectomy (2009-2022).
• Patients stratified into three age groups: <65, 65-74, and ≥75 years.
• Comparison of demographics, comorbidities, operative details, complications, pathology, and biochemical parameters.

Main Results:

• Older patients had more comorbidities (hypertension, cardiovascular disease, diabetes, osteoporosis, CKD); younger patients had more multiple endocrine neoplasias.
• No significant differences in hospital stay or complication rates (hypoparathyroidism, hungry bone syndrome, RLN injury) across age groups.
• Postoperative calcium and parathyroid hormone normalized in all groups; bone turnover markers improved across all ages, with greater reduction in younger patients.

Conclusions:

• Parathyroidectomy is a safe and effective treatment for PHPT in all age groups, including older patients with comorbidities.
• Age should not be a barrier to surgical intervention for PHPT, given the clear biochemical and skeletal benefits.
• Appropriate patient selection is key for successful surgical outcomes in elderly individuals.