Geriatric Thyroidectomy Safety of Thyroid Surgery in an Aging Population
Geriatric Thyroidectomy Safety of Thyroid Surgery in an Aging Population
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DOI：
10.1001/archoto.2009.138
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发表时间：
2009-10-01
影响因子：
--
通讯作者：
Terris, David J.
中科院分区：
文献类型：
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作者：
Seybt, Melanie W.;Khichi, Sunny;Terris, David J.
目的：确定老年人群中甲状腺手术是否存在增量风险。设计：对在学术卫生中心接受甲状腺手术的连续单外科医生系列患者进行前瞻性分析。地点：三级保健健康中心。患者：研究对象包括21岁至35岁的患者和65岁及以上的接受甲状腺切除术的患者。主要观察指标：病理报告、并发症(包括暂时性和永久性低钙血症、暂时性和永久性真性声带麻痹的发生率)、入院或再入院需求。结果：2003年11月至2007年12月，86名年轻患者接受了甲状腺切除术；44名老年患者在同一时间段内接受了手术。两组均无死亡，无血肿，也无永久性TVF瘫痪病例。与年轻人相比，老年患者的并发症发生率相似。这些患者包括一过性低钙血症(12.5%比11.1%)和一过性TVF麻痹(2.9%比3.9%)，但再住院率较高(4.5%比1.2%，P=.26)。结论：随着人口老龄化和甲状腺结节和甲状腺癌患病率的增加，高龄患者中甲状腺外科医生将面临更多的择期甲状腺手术。老年患者的甲状腺手术是安全的，并不比年轻患者的手术更危险。再入院率略高一些。
Objective: To ascertain whether there are incremental risks associated with thyroid surgery in the elderly population.Design: Prospective analysis of a consecutive single-surgeon series of patients undergoing thyroid surgery at an academic health center.Setting: Tertiary care health center.Patients: The study included patients aged 21 to 35 years and patients 65 years and older who under-went thyroidectomy.Main Outcome Measures: Pathology reports, complications (including rates of temporary and permanent hypocalcemia and temporary and permanent true vocal fold [TVF] paralysis), and need for admission or readmission were included in the analysis.Results: There were 86 youthful patients who underwent thyroidectomy between November 2003 and December of 2007; 44 elderly patients underwent surgery during that same time frame. There were no deaths in either cohort, no hematomas, and no cases of permanent TVF paralysis. The elderly patients had a similar rate of complications when compared with the youthful. patients, including transient hypocalcemia (12.5% vs i 11.1%, respectively) and temporary TVF paresis (2.9% vs 3.9%), but a higher rate of readmission (4.5% vs 1.2%, P=.26).Conclusions: 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. There is a slightly higher rate of readmission.