Presentation of hypoparathyroidism in Italy: a nationwide register-based study

• Published in: Journal of endocrinological investigation Vol. 47; no. 8; pp. 2021 - 2027
• Main Authors: Cipriani, C., Pepe, J., Colangelo, L., Cilli, M., Nieddu, L., Minisola, S.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 2024; Springer Nature B.V
• Subjects: Cancer; Cardiovascular disease; Cardiovascular diseases; Cardiovascular system; Cognitive ability; Diagnosis; Endocrinology; Hospitalization; Hypoparathyroidism; Infections; Internal Medicine; Kidney diseases; Kidney stones; Medicine; Medicine & Public Health; Mental disorders; Metabolic Diseases; Mortality; Nephrolithiasis; Original Article; Renal failure; Respiratory tract diseases; Seizures; Skin diseases; Italy; Italy; Hospitalization; Presentation; Complications; Hypoparathyroidism
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-023-02271-5

Purpose We sought to assess the clinical presentation of hypoparathyroidism (HypoPT) in Italy. Methods We performed a nationwide study retrieving data from the hospital discharge ICD-9 codes database of the Italian Health Ministry, from 2007 through 2017. The codes corresponding to diagnosis of cardiovascular disease, cancer, infection, renal failure, psychiatric disease, upper airway tract infection and pneumonia, seizures, nephrolithiasis, cognitive impairment, cerebral calcifications, skin disorders, fracture, and cataract were retrieved when associated with the diagnosis of HypoPT (252.1). We excluded codes corresponding to diagnoses of cancer of the neck region. In-hospital mortality rate was calculated. We retrieved the same data from an age- and sex-matched non-HypoPT control population. Results Fourteen thousand five hundred seventy-nine hospitalizations for HypoPT and controls were analyzed. Hospitalization for cardiovascular disease, cancer, infection, renal failure, seizures, nephrolithiasis, cerebral calcifications ( p  < 0.0001), and cognitive impairment ( p  < 0.05) were more common in HypoPT compared to controls. Mean age of HypoPT with cardiovascular disease, cancer, and renal failure was younger compared to controls ( p  < 0.0001). The OR of hospitalization for cardiovascular disease, cancer, renal failure, seizures (OR 2, 40, 48  and 1.6, respectively), and nephrolithiasis (OR 1.6) were significant in HypoPT compared to non-HypoPT. The OR of hospitalization for infection and cognitive impairment were significant only in HypoPT women (OR 1.3 and 2.3, respectively). In-hospital mortality rate was lower in HypoPT vs controls (0.5% and 3.7%; p  < 0.0001). Conclusion Hospitalizations for cardiovascular disease, cancer, and renal failure are more prevalent and occur at a younger age in HypoPT vs non-HypoPT. Hospitalizations for seizures and nephrolithiasis are frequent in HypoPT; those for infection and cognitive impairment are more common in HypoPT women.