Older adults who underwent thyroid surgery experienced more overall postsurgical complications and a longer mean length of stay when compared with propensity-matched younger controls; however, rates of organ-specific complications between groups were similar, according to findings published in the Journal of Surgical Research.
“In our study, we showed that elderly patients did have a higher overall complication rate, but that significance diminished when broken down by organ system,” Vardan Papoian, MD, MPH, a resident in the department of surgery at MedStar Georgetown University Hospital, and colleagues wrote. “This implies that a larger population may be necessary to evaluate system-based complication rates rather than overall complication rates. In addition, there was not a statistically significant higher rate of readmissions.”
In a retrospective study, Papoian and colleagues analyzed data from 313 patients aged at least 75 years who underwent thyroidectomy between 2001 and 2018. Using propensity score matching, researchers identified a control group of 313 adults younger than 75 years matched on sex, race, surgery type, insurance status and comorbidities quantified by the Charlson Comorbidity Index (72% women; 40% black). Researchers assessed total complications, including thyroid-specific and systemic complications.
Within the cohort, 84% underwent total thyroidectomy and the remainder underwent lobectomy.
Researchers observed a higher overall complication rate after thyroid surgery between older adults and matched controls (4.8% vs. 1.9%; P = .05), as well as a higher thrombotic complication rate (1.2% vs. 0; P = .04). However, there were no significant between-group differences for postoperative ED visits (7% vs. 6%), readmissions (11.5% vs. 8.6%), cardiovascular complications (1.3% vs. 0.6%), pulmonary complications (3.2% vs. 0.9%) or neurologic complications (1% vs. 0.3%) between older adults and matched controls, respectively. There were no reoperations in either group. Older patients had a longer mean length of stay after thyroid surgery vs. controls (2.64 days vs. 1.29 days; P < .01). Results were similar in analyses restricted to patients aged at least 80 years, according to researchers.
“With a properly selected control group, we were able to show that age by itself did increase the overall complication rate and the [length of stay], but not the rates of emergency room visits or readmissions,” the researchers wrote. “Age should not be a contraindication or deterrent to surgical intervention, but should be taken into account when counseling patients on the need for operation.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.