Diagnosis and surgical treatment of primary hyperparathyroidism in the elderly people / 中华内分泌外科杂志

ABSTRACT

Objective:To analyze the clinical characteristics of PHPT in elderly patients, as well as the safety and effectiveness of surgical treatment.Methods:179 patients with PHPT treated from Jan. 2000 to Dec. 2020 were analyzed retrospectively. They were divided into elderly group ( n=51) and non-elderly group ( n=128) according to whether they were over 60 years old at the time of operation. The clinical data of symptoms, complications, preoperative and postoperative blood calcium, phosphorus, ALP, PTH, surgical cure rate and complication rate of the two groups were analyzed retrospectively. T-test was used for measurement data comparison. χ2 test was used for enumeration data comparison and single factor analysis. Logistic regression analysis (forward method) was used for multivariate analysis. Results:The proportion of non-specific symptoms in the elderly group, including fatigue, dizziness, loss of appetite, memory decline, was higher than that in the non-elderly group (21.6% vs 8.6%, P=0.019) . Elderly patients had lower blood ALP level[ (163.4±229.8) U/L vs (325.9±449.2) U/L, P=0.016], higher proportion of preoperative hypertension (47.1% vs 21.1%, P=0.001) , diabetes (31.4% vs 10.9%, P=0.001) , coronary heart disease (13.7% vs 3.1%, P=0.013) and tumor (13.7% vs 3.9%, P=0.025) . High proportion of non-specific symptoms was related to higher blood calcium [ OR=4.936 (95% CI 1.126-21.637) , P=0.034] and lower blood phosphorus[ OR=0.011 (95% CI 0.000-0.650) , P=0.030]. Between the two groups there was no significant difference in cure rate (94.1% vs 96.1%, P=0.564) or complication rate (27.5% vs 44.5%, P=0.127) . Conclusions:The surgical treatment of elderly patients with PHPT also has high effectiveness and safety. More attention should be paid to surgical diagnosis and treatment of elderly patients.