Volume 90, Issue 2 pp. 285-292
ORIGINAL ARTICLE

Increased mortality and morbidity in patients with chronic hypoparathyroidism: A population-based study

Thenmalar Vadiveloo

Corresponding Author

Thenmalar Vadiveloo

Dundee Epidemiology and Biostatistics Unit, Division of Clinical and Population Sciences and Education, University of Dundee, Dundee, UK

Correspondence

Thenmalar Vadiveloo, Dundee Epidemiology and Biostatistics Unit, University of Dundee, Dundee, UK.

Email: [email protected]

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Peter T. Donnan

Peter T. Donnan

Dundee Epidemiology and Biostatistics Unit, Division of Clinical and Population Sciences and Education, University of Dundee, Dundee, UK

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Callum J. Leese

Callum J. Leese

Royal Devon and Exeter Hospital, Exeter, UK

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Kirstin J. Abraham

Kirstin J. Abraham

Royal Devon and Exeter Hospital, Exeter, UK

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Graham P. Leese

Graham P. Leese

Department of Medicine, University of Dundee, Dundee, UK

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First published: 30 October 2018
Citations: 72

Summary

Objectives

A population-based study was undertaken to determine the mortality and morbidity for people with hypoparathyroidism compared to the general population.

Methods

In this study, patients identified with chronic hypoparathyroidism using data linkage from regional datasets were compared with five age- and gender-matched controls from the general population. Data from biochemistry, hospital admissions, prescribing and the demographic dataset were linked. Outcomes for mortality and specified conditions were examined for all patients and subdivided into post-surgical and non-surgical cases of hypoparathyroidism.

Results

All patients had an increased risk of epilepsy (HR 1.65 [95% CI 1.12-2.44]) and cataracts (HR 2.10 [1.30-3.39]) but no increased fracture risk. Only non-surgical hypoparathyroid patients also had increased mortality (HR 2.11 [1.49-2.98]), cardiovascular disease (HR 2.18 [1.41-3.39]), cerebrovascular disease (HR 2.95 [1.46-5.97]), infection (HR 1.87 [1.2-2.92]) and mental illness (HR 1.59 [1.21-2.11]). There was an increased risk of renal failure (HR 10.05 [95% CI 4.71-21.43]) during the first 2000 days (5.5 years) of follow-up. Renal failure and death were associated with increasing serum calcium concentrations.

Conclusion

Patients with hypoparathyroidism have an increased risk of cataract and epilepsy. Non-surgical hypoparathyroidism is associated with increased mortality and additional morbidities.

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