PMID- 9528728
OWN - NLM
STAT- MEDLINE
DCOM- 19980408
LR  - 20220330
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 104
IP  - 2
DP  - 1998 Feb
TI  - Survival after the diagnosis of hyperparathyroidism: a population-based study.
PG  - 115-22
AB  - BACKGROUND: Reports of increased mortality from cardiovascular disease and 
      malignancy in primary hyperparathyroidism have been based primarily on patients 
      who have undergone parathyroidectomy. In order to assess the true impact of 
      primary hyperthyroidism on mortality in the general population, we assessed 
      survival in a large inception cohort of Rochester, Minnesota residents with 
      primary hyperparathyroidism initially diagnosed over a 28-year span, the majority 
      of whom were followed with uncomplicated disease. METHODS: All Rochester 
      residents with primary hyperparathyroidism first recognized in 1965 to 1992 were 
      identified through the Rochester Epidemiology Project medical records linkage 
      system. Included as cases were patients with pathologic confirmation of 
      hyperthyroidism, hypercalcemia with inappropriately elevated parathyroid hormone 
      levels, or hypercalcemia for more than a year with no other cause. 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. 
      RESULTS: During the study period, 435 cases of primary hyperparathyroidism were 
      identified. Altogether, parathyroid surgery was performed on 126 patients (29%), 
      with a mean delay between the initial elevated serum calcium level and surgery of 
      3.3 years. Patients who underwent surgery had higher maximum serum calcium levels 
      than the patients who were observed (mean+/-SD, 11.3+/-0.7 versus 10.7+/-0.4 
      mg/dL, P <0.00 1), but their mean ages were similar (54+/-16 versus 56+/-17 
      years). Overall survival in the patients with primary hyperthyroidism was better 
      than expected (P=0.02), but by age-adjusted multivariate analysis, higher maximal 
      serum calcium level was an independent predictor of mortality (RR=1.3 per mg/dL; 
      95% CI: 1.1-1.6; P <0.02). CONCLUSION: Overall survival is not adversely affected 
      among unselected patients with mild primary HPT in the community, although 
      patients with more severe disease, as manifested by higher serum calcium levels, 
      may have an increased risk of death.
FAU - Wermers, R A
AU  - Wermers RA
AD  - Division of Endocrinology/Metabolic Diseases and Internal Medicine, Mayo Clinic 
      and Mayo Foundation, Rochester, Minnesota 55905, USA.
FAU - Khosla, S
AU  - Khosla S
FAU - Atkinson, E J
AU  - Atkinson EJ
FAU - Grant, C S
AU  - Grant CS
FAU - Hodgson, S F
AU  - Hodgson SF
FAU - O'Fallon, W M
AU  - O'Fallon WM
FAU - Melton, L J 3rd
AU  - Melton LJ 3rd
LA  - eng
GR  - AG 04875/AG/NIA NIH HHS/United States
GR  - AR 30582/AR/NIAMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Parathyroid Hormone)
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Calcium/blood
MH  - Cause of Death
MH  - Humans
MH  - Hyperparathyroidism/blood/diagnosis/*mortality/surgery
MH  - Minnesota/epidemiology
MH  - Parathyroid Hormone/blood
MH  - *Population Surveillance
MH  - Risk
MH  - Risk Factors
MH  - Survival Rate
EDAT- 1998/04/07 02:02
MHDA- 2001/03/28 10:01
CRDT- 1998/04/07 02:02
PHST- 1998/04/07 02:02 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1998/04/07 02:02 [entrez]
AID - S0002934397002702 [pii]
AID - 10.1016/s0002-9343(97)00270-2 [doi]
PST - ppublish
SO  - Am J Med. 1998 Feb;104(2):115-22. doi: 10.1016/s0002-9343(97)00270-2.