{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:12:51Z","timestamp":1791195171325,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T00:00:00Z","timestamp":1581465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T00:00:00Z","timestamp":1581465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T00:00:00Z","timestamp":1581465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Risks of thyroidectomy for multinodular goiter (MNG) in older and frail patients are unclear, particularly regarding hematoma and recurrent laryngeal nerve (RLN) palsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MNG patients undergoing total thyroidectomy were reviewed in the ACS\u2010NSQIP procedure\u2010targeted database (2016\u20132017). Outcomes were analyzed between adult (age &lt;65), older\u2010adult (age \u226565 and &lt;80), and oldest\u2010old (age \u226580) patients. Five\u2010factor modified frailty index (mFI\u20105) was calculated based on functional status, diabetes, COPD, CHF, and hypertension, and used in comparative analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2189 adult, 635 older\u2010adult, and 59 oldest\u2010old patients were included. Compared to adult patients, older\u2010adult and oldest\u2010old patients had higher mFI\u20105 \u22650.4 rates (14% vs. 22% vs. 31%, respectively, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The overall complication rate was 17.0% and similar between groups; however, oldest\u2010old patients had higher rates of surgical site infection (3.4% vs. 0.3% vs. 0.4%), pneumonia (5.1% vs. 0.3% vs. 0.2%), and readmission (10.2% vs. 2.4% vs. 2.6%) compared to older\u2010adult and adult patients, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). On multivariable analyses of thyroidectomy\u2010specific complications, mFI\u20105 \u22650.4 (OR 2.5, 95%\u2010CI 1.4\u20134.4) and bleeding disorder (OR 4.6, 95%\u2010CI 1.3\u201316.3) were predictive of hematoma, whereas vessel\u2010sealant device usage (OR 0.4, 95%\u2010CI 0.3\u20130.7) was protective. mFI\u20105 \u2265 0.4 (OR 1.5, 95%\u2010CI 1.1\u20132.2), bleeding disorder (OR 2.8, 95%\u2010CI 1.04\u20137.8), parathyroid autotransplantation (OR 1.7, 95%\u2010CI 1.2\u20132.6), and prolonged operative time (OR 1.4, 95%\u2010CI 1.02\u20131.8) were predictive of RLN palsy. Age was not a significant predictor of hematoma or RLN palsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients \u226580 years old are at increased risk for systemic complications and readmission after thyroidectomy for MNG. Frailty index better risk\u2010stratifies patients than age for thyroidectomy\u2010specific complications.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05422-4","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T17:02:42Z","timestamp":1581526962000},"page":"1876-1884","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Frailty is More Predictive than Age for Complications After Thyroidectomy for Multinodular Goiter"],"prefix":"10.1002","volume":"44","author":[{"given":"Brendan M.","family":"Finnerty","sequence":"first","affiliation":[{"name":"Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine 525 E 68th Street, F\u2010838 10065 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine D.","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine 525 E 68th Street, F\u2010838 10065 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy M.","family":"Ullmann","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine 525 E 68th Street, F\u2010838 10065 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasa","family":"Zarnegar","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine 525 E 68th Street, F\u2010838 10065 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Thomas J.","family":"Fahey","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine 525 E 68th Street, F\u2010838 10065 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toni","family":"Beninato","sequence":"additional","affiliation":[{"name":"Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine 525 E 68th Street, F\u2010838 10065 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,12]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"527","article-title":"Evaluation and management of multinodular goiter","volume":"29","author":"Hurley DL","year":"1996","journal-title":"Otolaryngol Clin N Am"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109343(90)90178\u2010G"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24886"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2018.10.052"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.2807"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.08.428"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26707"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25712"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005752"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.03.057"},{"key":"e_1_2_7_12_1","unstructured":"American College of Surgeons(2019)National surgical quality improvement program national surgical quality improvement program.https:\/\/www.facs.org\/quality\u2010programs\/acs\u2010nsqip. 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