(304) Same-Day Discharge Following Total Thyroidectomy in the Geriatric Population

Introduction: Same-day surgery (SDS) after total thyroidectomy has increased nationally. This study evaluates trends in SDS among patients aged 65 years or older, with particular focus on changes following the COVID-19 pandemic.

Methods: This is a retrospective cohort study at a single tertiary care center. Thyroidectomy procedures between January 1, 2016, and January 1, 2026, were reviewed. Patients were stratified by discharge status (SDS versus admission) and age ( < 65 versus ≥ 65 years). Subgroup analyses were conducted among septuagenarians, octogenarians, and patients older than 90 years. Discharge patterns were compared before and after March 1, 2020, marking the onset of the COVID-19 pandemic. Two-sample proportion tests with 95% confidence intervals were used for comparisons.

Results: Over a 10-year period, 3,962 thyroidectomy procedures were performed with 895 (22.6%) patients aged > 65 years. There were 2,655 total thyroidectomies and 567 (21.4%) were aged > 65 years old. Geriatric patients were less likely to undergo SDS than younger patients (24.3% versus 32.7%, p < 0.001). Within the geriatric cohort, SDS rates declined with increasing age: 26.3% among patients aged 70–79 years, 12.7% among those aged 80–89 years, and 0% among patients older than 90 years. SDS utilization increased significantly in all age groups after March 1, 2020, from 13.5% pre-pandemic to 42.5% post-pandemic (p < 0.001).

Conclusions: Same-day discharge following total thyroidectomy has increased approximately threefold at our institution since the onset of the COVID-19 pandemic. Although older patients remain less likely to undergo SDS than younger patients, outpatient management has become increasingly common in the geriatric population. These findings support further refinement of risk stratification strategies to safely expand outpatient thyroid surgery in older adults.