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Survival in primary hyperparathyroidism over five decades (1965-2010) a population-based retrospective study.
Wermers, Robert A; Griebeler, Marcio L; Thapa, Prabin; Hathcock, Matthew A; Kearns, Ann E.
Afiliação
  • Wermers RA; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Mayo Clinic, Rochester, MN, USA.
  • Griebeler ML; Cleveland Clinic, Cleveland, OH, USA.
  • Thapa P; Divisions of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
  • Hathcock MA; Divisions of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
  • Kearns AE; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: kearns.ann@mayo.edu.
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 OUTCOME

MEASURE:

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.
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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

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