Health status improvement after surgical correction of primary hyperparathyroidism in patients with high and low preoperative calcium levels

Background. We conducted a prospective cohort study to determine whether there are differences in functional health status between patients with low (<10.9 mg/dL) and high (greater than or equal to 10.9 mg/dL) serum calcium levels before surgical correction of primary hyperparathyroidism (HPT) and to compare changes in health status after correction of primary HPT. Methods. The SF-36 Health Survey, which provides demographic and condition-specific information, was used to obtain information on patients with primary HPT seen in a university hospital endocrine surgery clinic over a 4-year period before operation and again 2 months and 6 months after operation. Results. A total of 155 patients were studied; 86 had calcium levels <10.9 mg/dL (normal <10.5 mg/dL) and 69 had serum calcium levels greater than or equal to 10. 9 mg/dL (range 10.9 to 13.4 mg/dL). One hundred four patients completed 6-month reports, 55 with low calcium levels and 49 with high calcium levels. Both high and low calcium groups showed marked and virtually identical impairment of functional health status. Both groups showed marked improvement in health status at 2 months and additional improvement at 6 months, returning to normal or near normal in 6 of 8 SF-36 domains. Conclusions. Patients with primary hyperparathyroidism have significant functional health status impairment independent of the level of serum calcium. Dramatic improvement is seen after surgical correction. Referral for surgical treatment of primary HPT should not be delayed until serum calcium is elevated, as recommended in the 1990 National Institutes of Health consensus statement.