World Journal of Endocrine Surgery

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VOLUME 15 , ISSUE 2 ( May-August, 2023 ) > List of Articles


Long-term Survival Following Parathyroidectomy for Primary Hyperparathyroidism in Elderly People with Polypharmacy

Shaun F Purkiss

Keywords : Administrative data, Australia, Parathyroidectomy, Parathyroids, Polypharmacy, Primary hyperparathyroidism

Citation Information : Purkiss SF. Long-term Survival Following Parathyroidectomy for Primary Hyperparathyroidism in Elderly People with Polypharmacy. World J Endoc Surg 2023; 15 (2):29-33.

DOI: 10.5005/jp-journals-10002-1457

License: CC BY-NC 4.0

Published Online: 30-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: Primary hyperparathyroidism (PHP) is associated with many chronic conditions. Polypharmacy may, therefore, be a feature of those people with PHP considered for parathyroidectomy. This study examines the medication profile of elderly people undergoing parathyroidectomy for PHP and the association of polypharmacy with long-term survival. Materials and methods: A publicly available Australian administrative data source describing medical services and pharmacy dispensing between 2003 and 2015 was used. Persons undergoing parathyroidectomy for PHP aged >60 years were identified from procedure codes and their dispensing profile was examined in the year prior to surgery. Polypharmacy was defined as taking more than five concomitant medications. Survival following parathyroidectomy was assessed in relation to age and polypharmacy groupings. Results: A total of 608 persons (461:147, F:M) undergoing parathyroidectomy for PHP (mean age 72.1 years) were recruited. The prevalence of polypharmacy in parathyroidectomy-treated persons was 42%. Polypharmacy prevalence and cardiovascular treatment prevalence increased with age but were lower than control groups. Overall, 5-year survival following parathyroidectomy for PHP was 91% (controls 88%, log-rank 0.01) and was influenced by the level of polypharmacy in all groups. The elderly aged >75 years with polypharmacy had better survival following parathyroidectomy than controls (5-year survival 0.90 vs 0.77, log-rank 0.002). Conclusion: The prevalence of polypharmacy and cardiovascular treatments in this elderly Australian cohort undergoing parathyroidectomy for PHP is lower than controls. The long-term survival of those aged >75 with polypharmacy is better than age-matched controls. It is likely that patients undergoing parathyroidectomy for PHP are a highly selected group. Clinical significance: Administrative data can provide a perspective of people undergoing parathyroidectomy for PHP and examine survival outcomes. Presently, Australian surgeons are rigorous in the selection of elderly patients undergoing surgery such that long-term survival outcomes appear better than those observed in control populations.

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