Survival in primary hyperparathyroidism over five decades (1965-2010) a population-based retrospective study.
Bone
; 152: 116099, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-34245931
ABSTRACT
CONTEXT Survival in patients with primary hyperparathyroidism (PHPT) remains uncertain. OBJECTIVE:
To update survival in patients with PHPT in a United States community population.DESIGN:
Retrospective cohort study.SETTING:
Community population in Rochester, Minnesota.PARTICIPANTS:
Residents who met criteria for PHPT from 1965 to 2010.INTERVENTIONS:
Survival was estimated using the Kaplan Meier product-limit method. The Cox proportional hazards model was used to determine associations, as relative hazards (RR) with 95% confidence intervals (CI), of various risk factors with time to death. MAIN OUTCOMEMEASURE:
The overall age and gender-adjusted survival compared to white Minnesota residents.RESULTS:
We identified 1139 PHPT individuals, 76% female, with a median age of 58 years. Most were observed without parathyroidectomy (69%). The relative risk of death among the entire cohort was 0.996 (95% CI 0.91-1.09, P = 0.935) which was not different compared to Minnesota residents. Those with maximum serum calcium level ≥ 10.8 mg/dL (0.7 mg/dL above the reference range) had an increase in mortality (RR 1.32, 95% CI 1.10-1.58, P = 0.002). Survival among all PHPT individuals after parathyroidectomy was no different from expected (RR = 1.06, 95% CI 0.89-1.28; P = 0.508). Mortality was significantly decreased after parathyroidectomy in those with serum calcium levels ≥10.8 mg/dL (HR 0.47, 95% CI 0.36-0.61, P < 0.001).CONCLUSIONS:
Mortality in the entire cohort was not different from expected. PHPT patients with a maximum serum calcium level ≥ 10.8 mg/dL had increased mortality. Survival was improved after parathyroidectomy in those with this degree of hypercalcemia.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hiperparatireoidismo Primário
/
Hipercalcemia
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Bone
Assunto da revista:
METABOLISMO
/
ORTOPEDIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos