Safety of Thyroid Surgery in Older Adults

thyroid surgery depicted with pieces of a puzzleHow safe is surgery as a treatment for thyroid diseases in aging patients? Because thyroid diseases are common in geriatric populations, a team of researchers in Italy set out to attain a better understanding of the safety of treatment options for elderly adults.

A team led by researchers in the Department of Medical and Surgical Sciences at Magna Graecia University in Italy conducted a review of past literature to explore this topic. The study, “Thyroid surgery in geriatric patients: a literature review,” was published online ahead of print in November 2012. It appears in the journal BMC Surgery.

The study authors conducted a review of literature in September 2012 using the PubMed database. Specifically, they looked for articles that dealt with thyroid surgery and older adults. Publications from 2002 and on were included in the study.

The researchers analyzed 5 papers; 1 paper was a prospective, non-randomized study, and the other 4 were retrospective non-randomized studies. They constructed age cut-offs at 65, 70, 75, and 80 years. The researchers looked for complications of the surgeries, and post-operative morbidity and mortality. Additionally, one of the 5 studies examined the rate of re-hospitalization following thyroidectomy.

The results of the literature review showed that thyroid nodules are prevalent in geriatric
patients.  Participants who were aged 70 or older had a higher risk for post-surgical complications than patients who were younger than 70. However, the researchers concluded that thyroid surgery is generally safe for people over the age of 70, and that the more aggressive approach may be required given the high rates of toxic goiter and thyroid carcinoma in older patients.

The researchers recommend careful screening and risk assessment in aging patients prior to surgery—especially patients over the age of 80—since this may help reduce their risk of complications, re-hospitalizations, and mortality.

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