Older patients may have increased risk of complications and mortality after Thyroidectomy, suggests study
A new meta-analysis published in JAMA Otolaryngology – Head & Neck Surgery reported that older patients undergoing thyroidectomy experienced slightly higher rates of recurrent laryngeal nerve injury, postoperative hematoma, and mortality compared with younger patients.
A greater proportion of older patients (age ≥65 years) are undergoing thyroidectomy amidst an aging population. Given the elusive results in the literature, clarifying whether older patients face different thyroidectomy safety profiles is crucial for optimizing risk assessment and patient counseling.A Study was done to evaluate the association between older age (age ≥65 years) and thyroidectomy safety by comparing endocrine-related complications, including recurrent laryngeal nerve injury, hypocalcemia, hematoma, and mortality in older compared with younger patients.Cohort studies comparing thyroidectomy outcomes between older and younger patients and reporting endocrine-related complications were included. Two independent reviewers screened abstracts and full texts. Of 3192 studies identified, 11 met inclusion criteria. Two independent reviewers extracted data following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Risk of bias across studies was evaluated using the ROBINS-I (Risk of Bias in Nonrandomized Studies of Interventions) tool. Random-effects models were used to pool data. Results The analysis included 11 studies with a total of 427 886 patients of whom 104 232 (24.4%) were older adults (≥65 years). Older adults had greater odds of overall recurrent laryngeal nerve injury (2.3% vs 1.0%; OR, 1.58; 95% CI, 1.15-2.16; I2 = 76%), hematoma (2.4% vs 1.0%; OR, 2.32; 95% CI, 1.70-3.16; I2 = 0%), and mortality at last follow-up (0.3% vs 0.01%; OR, 11.09; 95% CI, 1.77-69.52; I2 = 90%) compared with younger patients. However, rates of overall hypocalcemia (OR, 0.80; 95% CI, 0.61-1.05; I2 = 71%) and wound complications (OR, 1.38; 95% CI, 0.92-2.06; I2 = 0%) were similar.
This systematic review and meta-analysis found that thyroidectomy is safe in older patients, with only small absolute increases in recurrent laryngeal nerve injury, hematoma, and mortality despite statistical significance. These findings support individualized counseling and perioperative planning while acknowledging the overall safety of thyroidectomy in this population.
Reference:
Ghani A, Ayesh AR, Rajaram H, et al. Thyroidectomy Outcomes in Older Adults: A Systematic Review and Meta-Analysis. JAMA Otolaryngol Head Neck Surg. Published online February 05, 2026. doi:10.1001/jamaoto.2025.5345
Keywords:
Thyroidectomy, Older patients, increased risk, complications, mortality, after, Ghani A, Ayesh AR, Rajaram H
