CLINICAL THYROIDOLOGY FOR PATIENTS
A publication of the American Thyroid Association
Complications of Thyroid Surgery in Octogenarians Are More Likely Caused by Underlying Illnesses than by Age Alone
ABBREVIATIONS & DEFINITIONS
Thyroidectomy — Surgery to remove the entire thyroid gland. When the entire thyroid is removed it is termed a total thyroidectomy. When less is removed, such as in removal of a lobe, it is termed a partial thyroidectomy.
What is the study about?
Thyroid nodules and thyroid cancer are the main reason to undergo surgery to remove all or part of the thyroid. Both of these conditions are common in older patients. However, older patients frequently have other chronic diseases as well, which makes thyroid surgery more difficult. This study examined the surgical complications that can occur in patients that undergo thyroid surgery. The aim of this study was to determine whether people over age 80 have higher rates of complications from surgery than other age groups.
The full article title: Mekel et al. Thyroid surgery in octogenarians is associated with higher complication rates. Surgery 2009;146:913-21.
What was the aim of the study?
The aim of this study was to determine whether people over age 80 have higher rates of complications from surgery than other age groups.
Who was studied?
The initial study group included 3,568 patients who had thyroid surgery at the Massachusetts General Hospital. A total of 90 patients in this group were 80 years of age or older. Another 242 patients from age 18 through 79 years were randomly selected from the group. These latter two groups were examined in this study.
How was the study done?
The patient’s records of the two groups were reviewed. The primary outcomes examined were complications that occurred within 30 days of surgery. Thyroid-specific complications such as hypocalcemia (low calcium levels) and vocal-cord problems were based on the whether the patient had to be re-admitted to the hospital.
What were the results of the study?
There were more complications in the group >80 than in the younger group. They also had a higher risk of surgery and a longer hospital stay than the younger group. However, age alone was not an independent risk factor in predicting complications after thyroid surgery. Men had more complications with thyroid surgery than women. Also, people who have underlying illnesses (co-morbidities) have more post-operative complications.
How does this compare with other studies?
One study found that you can predict the outcome of surgery from risk factors present before the operation. Another study found that among the older patients, the risk for post-operative complications was higher than younger patients. However, the study found that quality of life and survival rate following the diagnosis of thyroid cancer were increased in the elderly patients who had thyroid surgery.
What are the implications of this study?
This study is important because it shows that underlying illnesses and operative risk, not age alone, are important to evaluate in the elderly population when deciding to pursue thyroid surgery.
— Heather Hofflich, MD
ATA THYROID BROCHURE LINKS
Thyroid Surgery: http://www.thyroid.org/patients/patient_brochures/surgery.html
Thyroid Disease in the Older Patient: http://www.thyroid.org/patients/patient_brochures/older_patient.html