Assessment of changes in quality of life after thyroid surgery in older adults. A prospective study

Referral of older adults with thyroid nodular disease to surgery remains a challenge. We measured the impact of thyroid surgery on thyroid-related quality of life among older adults with nodular thyroid disease to aid decision-making.

In this prospective study, all patients aged> 60 years undergoing thyroid surgery for nodular thyroid disease completed the short-form Thyroid-Related Quality of Life (QoL) Patient-Reported Outcome (ThyPRO-39), expanded to include the full 85-item ThyPRO scales for physical thyroid symptoms, at admission and 6-12 months after surgery. Thyroid function testing, histological reports, and surgery extension were recorded. Wilcoxon tests were corrected for multiple comparisons, and linear mixed models were employed in the statistical analyses.

Of 88 patients (81% female, age 71 ± 6 years), 31 had malignant and 57 benign nodules. After surgery, patients showed a significant improvement (p < 0.01) in 10 of the 13 ThyPRO scales, four physical symptoms, two mental well-being scales (Anxiety and emotional susceptibility), all QoL Impairment scales, and the ThyPRO-39 Composite scale (30 ± 17 vs. 21 ± 13, p < 0.01). Improvements in physical symptoms and QoL impairment scales were observed primarily in the benign nodules group (p for interaction < 0.05). Although both lobectomy and total thyroidectomy improved QoL, lobectomized patients maintained T3 concentrations comparable to baseline.

Surgery improved most of the ThyPRO domains in older adults with nodular disease. Furthermore, goiter-related symptoms that impaired daily life and overall QoL improved primarily in benign disease. ThyPRO scores improved after both hemithyroidectomy and total thyroidectomy.