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Thyroidectomy Outcomes in Older Adults: A Systematic Review and Meta-Analysis
Ahmed Ghani1, Abdullah R Ayesh2, Harisanth Rajaram3
1School of Medicine, University College Dublin, Dublin, Ireland.
JAMA Otolaryngology-- Head & Neck Surgery
|February 5, 2026
Summary
Thyroidectomy is safe for older adults (≥65 years), with slightly increased risks of nerve injury, hematoma, and mortality. These findings support personalized patient counseling and perioperative planning for this growing demographic undergoing thyroid surgery.
Area of Science:
- Endocrinology
- Surgical Oncology
- Geriatric Medicine
Background:
- An increasing proportion of elderly patients (≥65 years) are undergoing thyroidectomy.
- Existing literature on thyroidectomy safety in older adults is inconclusive.
- Clarifying safety profiles is essential for risk assessment and patient counseling.
Purpose of the Study:
- To evaluate the safety of thyroidectomy in older patients (≥65 years).
- To compare endocrine-related complications and mortality between older and younger patients undergoing thyroidectomy.
Main Methods:
- Systematic search of Ovid MEDLINE, CINAHL, Embase, and Cochrane Library (inception to May 2025).
- Inclusion of 11 English-language cohort studies comparing thyroidectomy outcomes in older versus younger patients.
- Data extraction and risk of bias assessment using PRISMA and ROBINS-I guidelines, followed by random-effects meta-analysis.
Main Results:
- Analysis of 427,886 patients, with 24.4% aged ≥65 years.
- Older adults had higher odds of recurrent laryngeal nerve injury (OR, 1.58), hematoma (OR, 2.32), and mortality (OR, 11.09).
- Rates of hypocalcemia and wound complications were similar between age groups.
Conclusions:
- Thyroidectomy is generally safe in older patients.
- Small absolute increases in specific complication risks warrant consideration.
- Findings support individualized counseling and perioperative care for elderly patients undergoing thyroidectomy.
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