Hypothyroidism as a Predictor of Surgical Outcomes in the Elderly
Conclusions
It is recommended to post-pone elective surgery in elderly patients with hypothyroidism until an euthyroid state is achieved. If patients need urgent or emergent surgery, it is recommended to proceed with surgery only if they have mild or moderate hypothyroidism. Replacement therapy should be started preoperatively and there should be growing attention to the possible occurrence of minor post-operative complications in hypothyroid patients. As suggested by the American Thyroid Association (ATA), the treatment in elderly patients should be initiated at low doses with slow titration based on serum TSH evaluation. Elderly patients show higher normal serum TSH ranges; thus, higher serum TSH targets may be necessary as a patient ages. The suggested target serum TSH in people age 70–80 years is 4–6 mIU/L (8). Further clinical trials assessing surgical management in older hypothyroid patients are firmly required.
Author Contributions
MV, AMB, AB and FB conceived the review. MV and AMB wrote the manuscript and realized the figures and tables. SDS, SL, CB, RC and ESDV performed the literature search and critically revised the manuscript for important intellectual content.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
1. Roberts CG, Ladenson PW. Hypothyroidism. Lancet. (2004) 363:79...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
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