title: Increased costs of perioperative risk assessment for thyroid surgery in elderly people (over 80 years) presenting with benign disease.
abstract: OBJECTIVE
  Evaluate how surgical treatment of benign thyroid disease in elderly people is prone to induce an increase of costs in the next future due to the aging process of the population.
  
  
  METHODS
  A retrospective analysis has been performed on a total of 116 patients operated between January 2007 and September 2011, divided in a group of 58 patients aged over 80 years (Group A) and 58 patients younger than 80 years (Group B). The analyzed data included age, preoperative diagnosis, severe co-morbidities, procedures other than standard needed to evaluate anaesthesiological risk, postoperative hospital stay, complications, duration of postoperative intensive care monitoring, pathologic characteristics, and costs of anaesthesiological risk assessment.
  
  
  RESULTS
  Statistical analysis of collected data showed that the costs related to perioperative risk assessment (p value < 0.001) and the duration of hospital stay (p value < 0.001) were higher in Group A than in Group B. Instead, surgery-related complications were not statistically different.
  
  
  CONCLUSIONS
  Despite feasibility and safety of modern surgical techniques, indications for surgery in elderly patients affected by benign thyroid disease should be reserved mainly for those patients with severe medical necessity.
authors.affiliation: Department of Pathology, University of Pisa, Pisa, Italy. paolo.miccoli@dc.med.unipi.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Miccoli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fregoli
authors.forename: Rocco
authors.initials: R
authors.lastname: Rago
authors.forename: Valeria
authors.initials: V
authors.lastname: Matteucci
authors.forename: Mario
authors.initials: M
authors.lastname: Miccoli
authors.forename: Gabriele
authors.initials: G
authors.lastname: Materazzi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000706:statistics & numerical data / Q000639:trends; D003955:Diagnostic Tests, Routine / Q000191:economics; D005544:Forecasting; D006305:Health Status Indicators; D017721:Hospital Costs / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D007558:Italy; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends; D008875:Middle Aged; D011157:Population Dynamics; D011182:Postoperative Care / Q000191:economics; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology; D011300:Preoperative Care / Q000191:economics; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000191:economics* / Q000601:surgery*; D013965:Thyroidectomy / Q000191:economics*; D055815:Young Adult
references.citation: Arch Otolaryngol Head Neck Surg. 2009 Oct;135(10):1041-4
references.pmid: 19841346
references.citation: Age Ageing. 1999 Jul;28(4):363-6
references.pmid: 10459789
references.citation: Ann R Coll Surg Engl. 2011 Mar;93(2):149-51
references.pmid: 22041145
references.citation: J Clin Endocrinol Metab. 2012 May;97(5):1645-53
references.pmid: 22419716
references.citation: Ann Ital Chir. 1996 May-Jun;67(3):317-25
references.pmid: 9019982
references.citation: Eur J Endocrinol. 2006 Jun;154(6):787-803
references.pmid: 16728537
references.citation: Arch Surg. 2002 Nov;137(11):1243-8
references.pmid: 12413310
references.citation: Minerva Anestesiol. 2003 Apr;69(4):179
references.pmid: 12766703
references.citation: J Am Coll Surg. 2008 Jun;206(6):1097-105
references.pmid: 18501806
references.citation: Am J Surg. 2005 Sep;190(3):418-23
references.pmid: 16105529
references.citation: Anesthesiology. 2002 Feb;96(2):485-96
references.pmid: 11818784
references.citation: Surgery. 2009 Nov;146(5):913-21
references.pmid: 19744461
references.citation: Thyroid. 2009 Nov;19(11):1167-214
references.pmid: 19860577
references.citation: Lancet. 2000 Oct 14;356(9238):1286-7
references.pmid: 11073010
references.citation: Anesth Analg. 1995 May;80(5):896-902
references.pmid: 7726431
references.citation: Curr Treat Options Oncol. 2000 Oct;1(4):353-7
references.pmid: 12057160