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Study Examines Complications of Thyroid Surgery in Older Patients

CHICAGO -- October 19, 2009 -- In a study of patients undergoing thyroid surgery performed by a single surgeon, older adults did not appear to have more complications than younger patients. The results are published in the October issue of Archives of Otolaryngology-Head & Neck Surgery.

"As the population ages, surgery is being performed on geriatric patients more frequently on an elective basis than in decades past, for both malignant and benign diseases," the authors write. "Thyroid disorders, particularly those requiring surgical intervention, represent many of the conditions that must be managed, although little has been written about the geriatric patient population and the special challenges they may pose."

Surgery is usually considered more hazardous in older patients, but the increased risk may be due to co-occurring illnesses rather than age alone, the authors noted.

Melanie W. Seybt, MD, Medical College of Georgia, Augusta, Georgia, and colleagues analysed data from 86 younger (aged 21-35 years; mean age 29.5 years) and 44 older (>65 years; mean age, 71.3 years) patients who underwent thyroidectomy performed by a single surgeon between 2003 and 2007. They assessed pathology reports, complications, and the need for admission or readmission to the hospital.

No patients in either group died or experienced permanent vocal cord paralysis, and rates of complications were similar. For instance, 12.5% of older patients and 11.1% of younger patients experienced temporarily low blood calcium levels, and rates of temporary vocal cord paralysis were 2.9% among older and 3.9% among younger patients.

Older patients did have higher rates of readmission to the hospital (4.5% vs 1.2%), but the difference was not statistically significant. None of the readmissions were attributable to an age-related cause; rather, all were due to hypocalcemia.

"Thyroid surgeons will be faced more often with the prospect of elective thyroid surgery in patients of advanced age as an increasingly aged population emerges and the prevalence of thyroid nodules and thyroid cancer increases," the authors wrote.

"Thyroid surgery in elderly patients is safe and no more dangerous than surgery in youthful patients. Careful preoperative management of comorbid conditions is essential to performing safe thyroidectomy in patients of all ages."

SOURCE: Archives of Otolaryngology-Head & Neck Surgery

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