Elderly Thyroid Surgery Patients Face More Postoperative Complications

Elderly patients who undergo thyroid surgery are at a much higher risk than their younger counterparts for serious cardiac, pulmonary, and infectious complications, according to a new study.

Researchers at the University of Chicago Medical Center (UCM; IL, USA) and the University of California, San Francisco (UCSF; USA) analyzed a prospective cohort of 7,915 thyroidectomy cases and a control cohort of 3,575 parathyroidectomy cases reported to the American College of Surgeons (ACS) National Surgical Quality Improvement Program database between 2005 and 2008. The researchers then aggregated 83 complications into several outcome measures: urinary tract infection, wound infection, systemic infection, cardiac complications, pulmonary complications, 30-day mortality, and total hospital length of stay.

The results showed that increased age is a risk factor for significant pulmonary, cardiac, and infectious complications after thyroidectomy. Elderly patients (ages 65-79) are twice as likely, and the super-elderly (older than 80 years old) are five times as likely to have a complication compared with their young counterparts. Preexisting comorbidities are effect modifiers and increase the risk of complications even further. The study was published ahead of print on March 14, 2012, in the Journal of Clinical Endocrinology & Metabolism (JCEM).

“It is important that an elderly patient undergoing thyroid surgery have an experienced team of primary care physicians, surgeons, anesthesiologists and nurses who handle these types of surgeries on a routine, daily basis,” concluded lead author Raymon Grogan, MD, and colleagues of the UCM department of surgery. “It is important to understand that our study emphasizes the importance of the entire medical system that cares for these elderly patients, not just the surgeon.”

The number of thyroid operations being done in elderly patients is on the rise due to an increasing geriatric population, a steady increase in thyroid cancer incidence over the last 20 years, and a higher rate of benign thyroid pathology in the elderly.

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