Journal
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
Volume 208, Issue 6, Pages 1071-1076Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamcollsurg.2009.01.048
Keywords
-
Categories
Funding
- NATIONAL CANCER INSTITUTE [P30CA016672] Funding Source: NIH RePORTER
- NCI NIH HHS [P30 CA016672] Funding Source: Medline
Ask authors/readers for more resources
BACKGROUND: Elderly patients with primary hyperparathyroidism (PHPT) are often not referred for surgical intervention because of concern of comorbid conditions that may increase perioperative complications. Because PHPT is more common in the elderly, we sought to compare indications and complications of minimally invasive parathyroidectomy in patients 70 years of age and older (elderly) with their younger counterparts. STUDY DESIGN: A review was conducted of a prospectively collected database of all patients undergoing parathyroidectomy on our endocrine surgery service. Data collected included patient demographic, biochemical pathologic, and operative Findings. Wilcoxon rank sum and chi-square tests were used for comparisons. RESULTS: Three hundred eighty-eight patients with PHPT recently underwent parathyroidectomy over a 3-year period (elderly, n = 101; younger, n = 287). The elderly cohort had significantly higher median preoperative creatinine (elderly, 2.0 mg/dL; younger, 1.0 mg/dL; p = 0.002) and parathyroid hormone (elderly, 145 pg/mL; younger, 123 pg/mL; p = 0.026) levels. The elderly cohort also had more severe osteoporosis, with a significantly worse median bone mineral density T-score (elderly, -2.5; younger, -1.8; p < 0.001). The rate of postoperative complications was similarly low in both groups (elderly, 5.9%; younger, 3.5%; p = 0.38). CONCLUSIONS: Minimally invasive parathyroidectomy for PHPT can be performed as safely in elderly patients as in their younger counterparts. Elderly patients with PHPT are more likely to have osteoporosis and higher creatinine levels at the time of surgical referral. Additional study of the role of earlier intervention is warranted. (J Am Coll Surg 2009;208:1071-1076. (C) 2009 by the American College of Surgeons)
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available