Geriatric thyroidectomy: Safety of thyroid surgery in an aging population

Objective: To ascertain whether there are incremental risks associated with thyroid surgery in the elderly population. Design: Prospective analysis of a consecutive single-surgeon series of patients undergoing thyroid surgery at an academic health center. Setting: Tertiary care health center. Patients: The study included patients aged 21 to 35 years and patients 65 years and older who underwent thyroidectomy. Main Outcome Measures: Pathology reports, complications (including rates of temporary and permanent hypocalcemia and temporary and permanent true vocal fold [TVF] paralysis), and need for admission or readmission were included in the analysis. Results: There were 86 youthful patients who underwent thyroidectomy between November 2003 and December of 2007; 44 elderly patients underwent surgery during that same time frame. There were no deaths in either cohort, no hematomas, and no cases of permanent TVF paralysis. The elderly patients had a similar rate of complications when compared with the youthful patients, including transient hypocalcemia (12.5% vs 11.1%, respectively) and temporary TVF paresis (2.9% vs 3.9%), but a higher rate of readmission (4.5% vs 1.2%, P=.26). Conclusions: 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. Thyroid surgery in elderly patients is safe and no more dangerous than surgery in youthful patients. There is a slightly higher rate of readmission.