Thyroid Surgery Safe for Elderly Patients, No More
Dangerous Than in Youthful Patients
Another barrier to surgery on senior citizens falls
as older population continues boom
Oct. 21, 2009 The next bearer to fall in the
battle for surgery to treat senior citizens appears to be the one that
has stopped thyroid surgery for older people. A new study shows that in
thyroid surgery performed by a single surgeon, older adults did not
appear to have more complications than younger patients.
About 26% of seniors 65 and older in U.S. are
obese, nearly 40% are overweight, putting them at a higher risk for Type
2 diabetes, high blood pressure and heart disease
"As the population ages, surgery is being performed
on geriatric patients more frequently on an elective basis than in
decades past, for both malignant and benign diseases," the researchers
write in the October issue of Archives of OtolaryngologyHead & Neck
Surgery, one of the JAMA/Archives journals.
"Thyroid disorders, particularly those requiring
surgical intervention, represent many of the conditions that must be
managed, although little has been written about the geriatric patient
population and the special challenges they may pose."
The segment of the U.S. population older than 65
has increased by 90 percent during the past 30 years, according to the
article.
Surgery is usually considered more hazardous in
older patients, but the increased risk may be due to co-occurring
illnesses rather than age alone, the authors note.
Melanie W. Seybt, M.D., and colleagues at Medical
College of Georgia, Augusta, analyzed data from 86 younger (age 21 to
35, average age 29.5) and 44 older (older than age 65, average age 71.3)
patients who underwent thyroidectomy (surgery to remove all or part of
the thyroid) performed by a single surgeon between 2003 and 2007.
They assessed pathology reports, complications and
the need for admission or readmission to the hospital.
No patients in either group died or experienced
permanent vocal cord paralysis, and rates of complications were similar.
For instance, 12.5 percent of older patients and
11.1 percent of younger patients experienced temporarily low blood
calcium levels.
Rates of temporary vocal cord paralysis were 2.9
percent among older and 3.9 percent among younger patients.
Older patients did have higher rates of readmission
to the hospital (4.5% vs. 1.2%), but the difference was not
statistically significant.
None of the readmissions were attributable to an
age-related cause; rather, all were due to hypocalcemia (low calcium
levels).
"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," the authors conclude.
"Careful preoperative management of comorbid
[co-occurring] conditions is essential to performing safe thyroidectomy
in patients of all ages."
Keep up with the latest news for senior citizens, baby
boomers
Oct. 21, 2009 The next bearer to fall in the
battle for surgery to treat senior citizens appears to be the one that
has stopped thyroid surgery for older people. A new study shows that in
thyroid surgery performed by a single surgeon, older adults did not
appear to have more complications than younger patients.