Hypoparathyroidism plays more of indirect role in hospital visits: Study

Disorder is rarely main cause of hospitalization in study of patients in Austria

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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Hypoparathyroidism may play a role in serious health complications that require hospitalization for people with the disorder, but is rarely the direct cause of such problems, an Austrian study shows.

Findings indicate the most common causes of serious health issues among people with chronic (ongoing) hypoparathyroidism are related to complications from the disorder, suggesting it is a contributing factor in many cases.

Researchers also highlight a need for better awareness and more consistent documentation of hypoparathyroidism in clinical practice.

The study, “Hospitalizations, emergency room visits and causes of death in 198 patients with permanent hypoparathyroidism – a retrospective Austrian study (2005-2022),” was published in Endocrine Connections.

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Chronic hypoparathyroidism increases risk of health complications

People with chronic hypoparathyroidism are at increased risk of a number of health complications, including hypocalcemia (abnormally low calcium levels), neurological problems, and kidney disease. While these issues can be serious and even life-threatening in some cases, there’s not much data on the common causes of hospitalization or death for people with hypoparathyroidism.

A team of scientists in Austria reviewed data for 198 people with chronic hypoparathyroidism who were treated at their clinic from 2005 to 2022. About two-thirds of the patients were women, and the vast majority had developed hypoparathyroidism as a complication following neck surgery.

Over the 17-year period reviewed in the study, a total of 219 emergency room (ER) visits and 627 hospitalizations lasting more than one day were recorded among the patients. In a few cases — about 12% of the ER visits and 7% of the hospitalizations — the reason medical attention was needed was directly caused by hypoparathyroidism, with common disease symptoms such as muscle spasms and shortness of breath that are primarily attributable to low calcium levels.

For most ER visits and hospitalizations, however, the reason for seeking medical attention was not directly related to hypoparathyroidism, but was instead for other problems like kidney disease, broken bones, and issues related to heart health.

Surprisingly, patients in need for immediate treatment of [abnormal calcium level-]related symptoms were rarely the primary cause for presentation in the hospital,” the researchers wrote. 

Still, the team said that for many of these other health issues, hypoparathyroidism is a known risk factor. As such, it’s possible that hypoparathyroidism may be playing a role.

“Most patients presented with symptoms attributable to chronic organ damages that were not acutely related to HP [hypoparathyroidism] but a contributing role of HP appears possible,” they wrote. 

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Many of the 12 patients who died had hypoparathyroidism-related issues

Similarly, there were 12 deaths recorded over the study period, and while none of them were directly related to hypoparathyroidism, many of the patients had common hypoparathyroidism-associated complications like kidney disease or osteoporosis.

The researchers also noted that, although hypoparathyroidism was not the main cause of most serious medical problems, low calcium levels were documented in medical records for about half of the hospitalizations with available data — but calcium levels were measured only in about 71% of the hospital admissions.

In their review of patients’ medical records, the scientists found that the diagnosis of hypoparathyroidism is often missing from hospital documentation. Across all the patients’ paperwork, a total of 48 different diagnostic terms were used to refer to hypoparathyroidism or its direct complications, they noted.

“The awareness for HP was poor – only in 20% of cases was HP documented correctly. In 80% of all patients, HP was not documented at all or only terms like ‘previous parathyroidectomy’, ‘tetany’ or ‘hypocalcemia’ were used,’ ” the researchers wrote, adding that “the need for improved awareness in clinical practice appears evident.”