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Safety of Thyroid Surgery in the Elderly: A Propensity Score Matched Cohort Study.

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Citation: Journal of Surgical Research. 242:239-243, 2019 10.PMID: 31102915Institution: MedStar Washington Hospital CenterDepartment: Surgery/Endocrine SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Postoperative Complications/ep [Epidemiology] | *Thyroid Nodule/su [Surgery] | *Thyroidectomy/ae [Adverse Effects] | Age Factors | Aged | Aged, 80 and over | Female | Humans | Length of Stay/sn [Statistics & Numerical Data] | Male | Postoperative Complications/et [Etiology] | Propensity Score | Retrospective Studies | Risk Assessment/sn [Statistics & Numerical Data] | Thyroid Gland/su [Surgery]Year: 2019 ISSN:

0022-4804

Name of journal: The Journal of surgical researchAbstract: BACKGROUND: Thyroid surgery is becoming more common in the elderly as elderly population continues to grow. We aim to evaluate the relative risk of morbidity from thyroidectomy in patients greater than 75 y of age.CONCLUSIONS: Elderly patients did have a longer length of stay when compared to a matched younger population. Although there was a trend with higher complication rates in the elderly, those differences did not reach statistical significance.Copyright (c) 2019 Elsevier Inc. All rights reserved.METHODS: A retrospective analysis was performed for patients who were undergoing thyroidectomy between 2001 and 2018 in a multihospital network. A matched control group was selected with use of a propensity score, which was based on gender, ethnicity, type of surgery, insurance status, and comorbidities. The Charlson Comorbidity Index was used to quantify comorbidities. Total complications included both thyroid-specific and systemic complications.RESULTS: We identified 313 patients over the age of 75 y with a propensity score matched group of 313 patients. There was no difference between the percent female (73% versus 73%, P = 0.92), race composition (P = 0.91), insurance status (P = 0.99), percent undergoing total thyroidectomy (84% versus 84%, P = 0.91), and Charlson Index (2.6 versus 2.69, P = 0.70) of the two groups. Overall complications (4.8% versus 1.9%, P = 0.05) and thrombotic events (1.2 versus 0%, P = 0.04) were significantly higher but there was no statistically significant difference between postoperative emergency room visits (7% versus 6%, P = 0.61), readmissions (11.5% versus 8.6%, P = 0.18), cardiovascular (1.3 versus 0.6%, P = 0.61), pulmonary (3.2 versus 0.9%, P = 0.07), or neurologic complications (1.0 versus 0.3%, P = 0.34). No reoperations were noted in either group. Elder patients did have a longer length of stay (2.64 versus 1.29 d, P < 0.01).All authors: Carroll NM, Felger EA, Marji FP, Papoian V, Rosen JEOriginally published: Journal of Surgical Research. 242:239-243, 2019 May 15.Fiscal year: FY2020Fiscal year of original publication: FY2019Digital Object Identifier:

https://dx.doi.org/10.1016/j.jss.2019.04.012

Date added to catalog: 2019-06-21

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Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	31102915	Available		31102915

BACKGROUND: Thyroid surgery is becoming more common in the elderly as elderly population continues to grow. We aim to evaluate the relative risk of morbidity from thyroidectomy in patients greater than 75 y of age.

CONCLUSIONS: Elderly patients did have a longer length of stay when compared to a matched younger population. Although there was a trend with higher complication rates in the elderly, those differences did not reach statistical significance.

METHODS: A retrospective analysis was performed for patients who were undergoing thyroidectomy between 2001 and 2018 in a multihospital network. A matched control group was selected with use of a propensity score, which was based on gender, ethnicity, type of surgery, insurance status, and comorbidities. The Charlson Comorbidity Index was used to quantify comorbidities. Total complications included both thyroid-specific and systemic complications.

RESULTS: We identified 313 patients over the age of 75 y with a propensity score matched group of 313 patients. There was no difference between the percent female (73% versus 73%, P = 0.92), race composition (P = 0.91), insurance status (P = 0.99), percent undergoing total thyroidectomy (84% versus 84%, P = 0.91), and Charlson Index (2.6 versus 2.69, P = 0.70) of the two groups. Overall complications (4.8% versus 1.9%, P = 0.05) and thrombotic events (1.2 versus 0%, P = 0.04) were significantly higher but there was no statistically significant difference between postoperative emergency room visits (7% versus 6%, P = 0.61), readmissions (11.5% versus 8.6%, P = 0.18), cardiovascular (1.3 versus 0.6%, P = 0.61), pulmonary (3.2 versus 0.9%, P = 0.07), or neurologic complications (1.0 versus 0.3%, P = 0.34). No reoperations were noted in either group. Elder patients did have a longer length of stay (2.64 versus 1.29 d, P < 0.01).

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