The extent of improvement of health-related quality of life as assessed by the SF36 and Paseika scales after parathyroidectomy in patients with primary hyperparathyroidism - A systematic review and meta-analysis

•Parathyroidectomy for PHPT potentially improves function and quality of life.•However, there is no quantitative evidence to support this for all studies.•Provides evidence that parathyroidectomy improves the quality of life of PHPT patients.

Background: Previous studies have shown that parathyroidectomy for primary hyperparathyroidism (PHPT) improve the function and quality of life of patients. The aim of this systematic review and meta-analysis is to determine the health-related quality of life outcomes among those having surgical management for PHPT. Methods: Several databases were searched (MEDLINE, EMBASE, PubMed, Current Contents) for studies in which health-related quality of life was measured by reliable and validated instruments (SF-36 and Paseika Questionnaire) before and after parathyroidectomy for patients with primary hyperparathyroidism (PHPT). For the SF-36, score differences greater than 5 points indicate clinically relevant changes. Results: There were six studies with quality of life data. The SF-36 data was derived from 238 patients, with a mean age of 59 years and 71% were females. The range of follow up after surgery was 6 months to one year. The pre- and post-parathyroidectomy SF-36 quality of life scale scores were vitality (44 vs. 60, p < 0.001), physical functioning (51 vs. 69, p < 0.001), bodily pain (50 vs. 65, p < 0.001), general health (54 vs. 64, p < 0.001), role physical (34 vs. 52, p < 0.001), role emotional (43 vs. 59, p < 0.001), role social (60 vs. 74, p < 0.001), and mental health (55 vs. 71, p < 0.001). The Paseika data was derived from 203 patients, with a mean age of 54 years and 67% were females. The pre- and post-parathyroidectomy Paseika scores were feeling tired (51 vs. 19, p < 0.001), feeling thirsty (29 vs. 12, p < 0.001), mood swings (33 vs. 12, p < 0.001), joint pains (32 vs. 14, p < 0.001), irritability (31 vs. 10, p < 0.001), feeling blue (31 vs. 14, p < 0.001), feeling weak (37 vs. 15, p < 0.001), itchy (17 vs. 7, p < 0.001), forgetful (27 vs. 16, p < 0.001), headache (18 vs. 5, p < 0.001), abdominal pain (19 vs. 8, p < 0.001), bone pain (38 vs. 17, p < 0.001), ability to move off chair (27 vs. 11, p < 0.001). Conclusion: Parathyroidectomy significantly improves the short to medium-term health-related quality of life of patients suffering from primary hyperparathyroidism.