Z. T. Sahli1, G. Ansari1, J. K. Canner1, D. Segev1, M. A. Zeiger1, A. Mathur1 1Johns Hopkins University School Of Medicine,Department Of Surgery,Baltimore, MD, USA
Introduction: The rise in the geriatric population in the US along with the increasing prevalence of thyroid nodular disease and cancer will lead to a higher number of thyroidectomies performed in this age group. The impact of thyroidectomy in older adults is not well defined. The aim of our study was to evaluate surgical outcomes after thyroidectomy in older adults as compared to younger adults.
Methods: We conducted a retrospective cohort study using the American College of Surgeons National Surgery Quality Improvement Program database from 2012-2015. We included and categorized thyroidectomy patients into three age groups (18-64 years, 65-79 years, and ≥80 years) and analyzed 30-day perioperative outcomes using the bivariate X2 test and multivariate logistic regression to estimate risk of outcomes.
Results: Our study identified 39,859 patients who underwent thyroidectomy. Among our cohort, 31,315 (78.56%) patients were between 18-64 years, 8,544 (21.44%) were between 65-79 years, and 904 (2.27%) were ≥80 years. Compared to younger patients, patients ≥80 years were 2.25 times more likely to develop a complication (95% confidence interval [CI]: 1.58-3.20, p<0.001), 1.52 times more likely to have a longer hospital stay (95% CI: 1.18-1.96, p=0.001) and were associated with higher rates of hematoma (16.67%, p<0.001). Compared to younger patients, patients 65-79 years were 1.36 times more likely to develop a complication (95% CI: 1.12-1.64, p<0.001), 1.31 times more likely to have a reoperation (95% CI: 1.07-1.62, p=0.011), and 0.64 times more likely to have a lower rates of related readmission (95% CI: 0.47-0.87, p=0.004).
Conclusion: Patients ≥80 years have significantly higher rates of complications, longer lengths of stay, and incidence of neck hematomas. Patients 65-79 years have higher rates of complications and reoperation rates and lower rates of related readmission. Further studies are needed to risk stratify individuals within the aging population to counsel patients and potentially mitigate these risks.