Senior Citizen Thyroid Surgery Patients at Greater Risk of Postoperative Problems
Large study challenges assumption that thyroidectomy is a low-risk operation for elderly patients
March
29, 2012 - Elderly patients who undergo thyroid surgery are at a much higher risk than their younger counterparts for serious cardiac,
pulmonary and infectious complications, according to a recent study. Compared to younger patients, senior citizens (age 65-79) are twice as
likely and the super-elderly (age 80 and above) are five times as likely to have a postoperative complication.
The study findings challenge long-held beliefs that thyroidectomy carries the same risk level of postoperative
complications for both older and younger patients. It has been accepted for publication in The Endocrine Society's Journal of
Clinical Endocrinology & Metabolism (JCEM).
The number of thyroid operations being done in elderly patients is on the rise due to an increasing geriatric population,
a steady increase in thyroid cancer incidence over the last 20 years and a higher rate of benign thyroid pathology in the elderly.
In the current study, researchers wanted to know if age had an effect on postoperative risks in thyroidectomy patients
and found that elderly patients were at increased risk for major systemic complications.
"As the baby-boomer generation ages, the U.S. population is becoming increasingly older, and because of this, more
research with a focus on elderly patients needs to be a study priority," said Raymon H. Grogan, MD, of the University of Chicago in Illinois,
and lead author of the study.
"Our findings demonstrate this need by showing how conventional wisdom in the medical setting does not always apply to
the elderly population."
This is one of the largest studies ever performed that looks specifically at thyroid surgery and elderly patients. In
this study, researchers examined 7,915 thyroidectomy patients from the American College of Surgeons National Surgical Quality Improvement
Program database and noted outcome measures such as urinary tract infection, cardiac complications, total hospital length of stay and 30-day
mortality.
About the Thyroid
Your thyroid is a butterfly-shaped gland in your neck, just above your
collarbone. It is one of your endocrine glands, which make hormones. The thyroid helps set your metabolism - how your body gets energy
from the foods you eat.
Millions of people in the U.S. have thyroid diseases. Most of them are women. If
you have a thyroid disease, your body uses energy more slowly or quickly than it should.
A thyroid gland that is not active enough, called hypothyroidism, is far more
common. It can make you gain weight, feel fatigued and have difficulty dealing with cold temperatures.
If your thyroid is too active, it makes more thyroid hormones than your body
needs. That condition is hyperthyroidism. Too much thyroid hormone can make you lose weight, speed up your heart rate and make you
very sensitive to heat.
There are many causes for both conditions. Treatment involves trying to reset
your body's metabolism to a normal rate.
>> Thyroid Surgery –
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They found that when compared to younger patients, elderly patients (age 65-79) are twice as likely and the super-elderly
(age 80 and above) are five times as likely to have a postoperative complication.
"It is important to understand that our study emphasizes the importance of the entire medical system that cares for these
elderly patients, not just the surgeon," says Grogan.
"In our study elderly patients were susceptible to life-threatening, non-surgical complications. Thus it is important
that an elderly patient undergoing thyroid surgery have an experienced team of primary care physicians, surgeons, anesthesiologists and nurses
who handle these types of surgeries on a routine, daily basis."
Other researchers working on the study include: Elliot J. Mitmaker, Jimmy Hwang, Jessica E. Gosnell, Quan-Yang Duh, Orlo
H. Clark, and Wen T. Shen, all of the University of California San Francisco.
The article, "A Population-Based Prospective Cohort Study of Complications After Thyroidectomy in the Elderly," appears
in the May 2012 issue of JCEM.
Founded in 1916, The Endocrine Society reports it is the world's oldest, largest and most active organization devoted to
research on hormones and the clinical practice of endocrinology. The Endocrine Society's membership consists of over 15,000 scientists,
physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied and clinical interests in
endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society and the field of endocrinology, visit
www.endo-society.org. On Twitter at
https://twitter.com/#!/EndoMedia.
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