title: A population-based prospective cohort study of complications after thyroidectomy in the elderly.
abstract: BACKGROUND
  Data on the risk of postthyroidectomy complications in elderly patients are sparse, unclear, and conflicting.
  
  
  OBJECTIVE
  We sought to use a population-based cohort to determine whether thyroid operations in the elderly are as safe as those done in younger patients.
  
  
  METHODS
  This was a prospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2008, with 30-d postoperative follow-up.
  
  
  METHODS
  The American College of Surgeons National Surgical Quality Improvement Program data set contains operative cases from a nationwide sampling of academic and community-based as well as high-volume and low-volume hospitals.
  
  
  METHODS
  All thyroidectomy and parathyroidectomy patients reported to the database during the study period were included in the analysis resulting in an experimental cohort of 7915 thyroidectomy cases and a control cohort of 3575 parathyroidectomy cases.
  
  
  METHODS
  We aggregated 83 complications into the following outcome measures: urinary tract infection, wound infection, systemic infection, cardiac complications, pulmonary complications, 30-d mortality, and total hospital length of stay.
  
  
  RESULTS
  Increased age is a risk factor for significant pulmonary, cardiac, and infectious complications after thyroidectomy. Elderly patients are twice as likely (odds ratio 2.1, 95% confidence interval 1.4-3.3), and the superelderly are 5 times as likely (odds ratio 4.9, 95% confidence interval 2.5-9.6) to have a complication compared with their young counterparts. Preexisting comorbidities are effect modifiers and increase the risk of complications even further.
  
  
  CONCLUSIONS
  Elderly thyroidectomy patients are at increased risk for major systemic complications. A systematic approach to the care of elderly thyroidectomy patients is necessary to minimize their risk of serious postoperative complications.
authors.affiliation: Endocrine Surgery Research Program, Department of Surgery, Section of Endocrine Surgery, University of Chicago Medical Center, Chicago, Illinois 60637, USA. rgrogan@surgery.bsd.uchicago.edu
authors.forename: Raymon H
authors.initials: RH
authors.lastname: Grogan
authors.forename: Elliot J
authors.initials: EJ
authors.lastname: Mitmaker
authors.forename: Jimmy
authors.initials: J
authors.lastname: Hwang
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Gosnell
authors.forename: Quan-Yang
authors.initials: QY
authors.lastname: Duh
authors.forename: Orlo H
authors.initials: OH
authors.lastname: Clark
authors.forename: Wen T
authors.initials: WT
authors.lastname: Shen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D011446:Prospective Studies; D058996:Quality Improvement; D012307:Risk Factors; D013965:Thyroidectomy / Q000009:adverse effects*