Thyroidectomy in older adults: an American College of Surgeons National Surgical Quality Improvement Program study of outcomes.
Thyroidectomy in older adults: an American College of Surgeons National Surgical Quality Improvement Program study of outcomes.
复制标题
DOI：
10.1016/j.jss.2018.03.057
复制
发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Mathur A
中科院分区：
文献类型：
--
作者：
Sahli ZT;Ansari G;Gurakar M;Canner JK;Segev D;Zeiger MA;Mathur A
美国老年人口的增长加上甲状腺结节性疾病和癌症的增加将导致老年人甲状腺切除术的数量增加。我们的目的是评估老年人甲状腺切除术后的结果与年轻人相比。一项回顾性队列研究使用了2012-2015年美国外科医师学会国家手术质量改进计划（ACS-NSQIP）数据库，将甲状腺切除术患者分为3个年龄组：18-64岁、65-79岁和≥80岁。采用双变量×2检验和多变量Logistic回归分析30 d围手术期结局，以估计结局的风险。我们的研究确定了60，990例接受甲状腺切除术的患者：47，855例（78.4%）患者年龄在18-64岁之间，11，716例（19.2%）年龄在65-79岁之间，1，419例（2.3%）年龄≥80岁。与年轻成人相比，≥80岁的患者发生并发症的可能性高2.67倍（95%置信区间[CI]：2.02-3.53，p<0.001），因任何原因再次入院的可能性高1.83倍（95%CI：1.40-2.38，p<0.001），因甲状腺切除术相关原因而再次入院的可能性高1.54倍（95%CI：1.10-2.16，p<0.05），延长住院时间的可能性为1.66倍（95%CI：1.44-1.91，p<0.001）。65-79岁的患者发生并发症的可能性高1.40倍（95%CI：1.19-1.63，p<0.001）。≥65岁的患者总体并发症发生率显著较高。此外，≥80岁的患者总再入院率和甲状腺切除术相关再入院率较高，住院时间延长。
The growth of the US geriatric population coupled with the rise in thyroid nodular disease and cancer will result in an increased number of thyroidectomies performed in older adults. We aim to evaluate outcomes after thyroidectomy in older adults as compared to younger adults. A retrospective cohort study using the American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP) database from 2012–2015 categorized thyroidectomy patients into three age groups: 18–64 years, 65–79 years, and ≥80 years. Thirty-day perioperative outcomes were analyzed using bivariate ×2 test and multivariate logistic regression to estimate risk of outcomes. Our study identified 60,990 patients who underwent thyroidectomy: 47,855 (78.4%) patients between 18–64 years, 11,716 (19.2%) between 65–79 years, and 1,419 (2.3%) ≥80 years. Compared to younger adults, patients ≥80 years were 2.67 times more likely to develop a complication (95% confidence interval [CI]: 2.02–3.53, p<0.001), 1.83 times more likely to be readmitted for any reason (95%CI: 1.40–2.38, p<0.001), 1.54 times more likely to be readmitted for a reason related to the thyroidectomy (95%CI: 1.10–2.16, p<0.05), and 1.66 times more likely to have an extended hospital stay (95%CI: 1.44–1.91, p<0.001). Patients 65–79 years were 1.40 times more likely to develop a complication (95%CI: 1.19–1.63, p<0.001). Patients ≥65 years have significantly higher rates of overall complications. Additionally, patients ≥80 years have higher rates of total and thyroidectomy-related readmissions, and extended length of hospital stay.
登录
查看更多内容
影响因子：
3
作者：
Lang, BHH;Lo, CY
通讯作者：
Lo, CY
影响因子：
3.8
作者：
Mekel, Michal;Stephen, Antonia E.;Parangi, Sareh
通讯作者：
Parangi, Sareh
影响因子：
2.3
作者：
Bergenfelz, A.;Jansson, S.;Lausen, I.
通讯作者：
Lausen, I.
影响因子：
--
作者：
Seybt, Melanie W.;Khichi, Sunny;Terris, David J.
通讯作者：
Terris, David J.
影响因子：
3.6
作者：
AL-Qahtani, Khalid Hussain;Tunio, Mutahir A.;Fatani, Hanadi
通讯作者：
Fatani, Hanadi