Age-Related Trends of Thyroidectomies in Saudi Arabia: A Multicenter Retrospective Study.

Abstract

Background: Understanding the relationship between aging and postoperative complications is critical because it may influence how the condition is managed. The safety of thyroidectomy in the older age group is debated in literature. All previous studies were conducted outside of the Middle East, and there is a scarcity of data in the literature describing the relationship between age and postoperative outcomes after thyroidectomy. This study aimed to compare the clinical trends of patients undergoing thyroidectomy between younger and older age groups. Methodology: A multicenter retrospective study was conducted at 3 tertiary care centers in Jeddah, Saudi Arabia. Our inclusion criteria consisted of patients of all ages of both sexes who underwent thyroidectomy. Patients were divided into 2 age groups, <60 years and ≥60 years. Chi-square test and independent t test were used to evaluate the differences between qualitative and continuous variables. Logistic regression analysis was performed with postoperative complications and length of hospitalization as the dependent variables. Results: A total of 798 patients were included in this study. The <60 years age group was comprised of 81% female patients and 19% male patients, compared to 63.4% female patients and 36.6% male patients in the ≥60 years age group (P < .001). The ≥60 years age group had a statistically significant longer mean postoperative length of hospitalization (5.37 ± 7.21 days) compared to the <60 age group (3.33 ± 4.24 days; P = .003). A total of 14.4% of the patients in the <60 years age group developed at least one postoperative complication compared to 17.9% of the patients in the ≥60 years age group (P = .385). Seroma and recurrent laryngeal nerve injury occurred more commonly in the ≥60 years age group compared to the <60 years age group with a statistically significant difference (P = .003 and P < .001, respectively). In contrast, hypocalcemia occurred more commonly in patients of the <60 years age group with a statistically significant difference (P = .044). These findings were further verified by multivariate logistic regression after adjustment for gender, type of procedure, and type of diagnosis. Conclusion: In our region, the overall risk of developing postoperative complications was not different between the younger and older age groups. However, certain complications were more likely to develop in the older age group which requires vigilance from surgeons performing thyroidectomy. Likewise, the length of hospitalization was significantly longer in the older population. Awareness of complications and challenges of thyroidectomy in the older age group is crucial to improve care.