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J Clin Endocrinol Metab. 2012 May;97(5):1645-53. doi: 10.1210/jc.2011-1162. Epub 2012 Mar 14.

A population-based prospective cohort study of complications after thyroidectomy in the elderly.

Author information

  • 1Endocrine Surgery Research Program, Department of Surgery, Section of Endocrine Surgery, University of Chicago Medical Center, Chicago, Illinois 60637, USA. rgrogan@surgery.bsd.uchicago.edu

Abstract

CONTEXT:

Data on the risk of postthyroidectomy complications in elderly patients are sparse, unclear, and conflicting.

OBJECTIVE:

We sought to use a population-based cohort to determine whether thyroid operations in the elderly are as safe as those done in younger patients.

DESIGN:

This was a prospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2008, with 30-d postoperative follow-up.

SETTING:

The American College of Surgeons National Surgical Quality Improvement Program data set contains operative cases from a nationwide sampling of academic and community-based as well as high-volume and low-volume hospitals.

PATIENTS:

All thyroidectomy and parathyroidectomy patients reported to the database during the study period were included in the analysis resulting in an experimental cohort of 7915 thyroidectomy cases and a control cohort of 3575 parathyroidectomy cases.

MAIN OUTCOME MEASURES:

We aggregated 83 complications into the following outcome measures: urinary tract infection, wound infection, systemic infection, cardiac complications, pulmonary complications, 30-d mortality, and total hospital length of stay.

RESULTS:

Increased age is a risk factor for significant pulmonary, cardiac, and infectious complications after thyroidectomy. Elderly patients are twice as likely (odds ratio 2.1, 95% confidence interval 1.4-3.3), and the superelderly are 5 times as likely (odds ratio 4.9, 95% confidence interval 2.5-9.6) to have a complication compared with their young counterparts. Preexisting comorbidities are effect modifiers and increase the risk of complications even further.

CONCLUSIONS:

Elderly thyroidectomy patients are at increased risk for major systemic complications. A systematic approach to the care of elderly thyroidectomy patients is necessary to minimize their risk of serious postoperative complications.

PMID:
22419716
[PubMed - indexed for MEDLINE]
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