AI Article Synopsis
- The study aimed to determine if parathyroidectomy (surgery for overactive parathyroid glands) improves frailty compared to thyroid surgery.
- Prior to surgery, patients undergoing parathyroid exploration had higher frailty scores than those undergoing thyroid surgery, indicating they were more frail.
- After surgery, parathyroid patients showed a significant improvement in frailty scores and were less likely to experience an increase in frailty, suggesting that parathyroidectomy helps maintain their health better over time.
Article Abstract
Background: Frailty tools assess symptoms and comorbidities that may coincide with those of primary hyperparathyroidism. To test the hypothesis that parathyroidectomy improves frailty, we conducted a prospective cohort comparison of frailty after parathyroid or thyroid surgery.
Methods: The Risk Analysis Index measuring frailty was prospectively administered to patients undergoing curative parathyroid exploration or total thyroidectomy. Risk Analysis Index results at the preoperative, postoperative, and last follow-up visits were assessed longitudinally.
Results: Compared to total thyroidectomy patients (n = 142), parathyroid exploration patients (n = 187) were older (P = .001), more often male (P = .05) and had longer surgical follow-up (P < .001). Mean preoperative Risk Analysis Index scores were higher in parathyroid exploration patients (24 ± 9 vs total thyroidectomy 17 ± 8, P < .001). Parathyroid exploration patients demonstrated a significant decrease in Risk Analysis Index score from preoperative to last follow-up (P < .01); total thyroidectomy patients did not (P = .44). Parathyroid exploration patients were also less likely to exhibit a 20% increase in Risk Analysis Index over time, suggesting that parathyroidectomy slowed progression of frailty (2% vs 19%, P = .003).
Conclusion: In this prospective study of frailty using a validated assessment tool, Risk Analysis Index scores decreased after parathyroid exploration surgery. When compared to total thyroidectomy patients, parathyroid exploration patients were also less likely to suffer a clinically meaningful ≥20% increase in Risk Analysis Index scores after surgery, suggesting that parathyroid exploration patients better maintained baseline health at final follow-up.
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| http://dx.doi.org/10.1016/j.surg.2021.10.055 | DOI Listing |
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