- Older patients had higher rates of recurrent laryngeal nerve injury, hematoma, and mortality, but absolute differences were small (≈1 percentage point for most complications).
- Rates of hypocalcemia, wound complications, and operative time did not differ between older and younger patients.
- Permanent recurrent laryngeal nerve injury was more common in older patients, while transient injury rates were similar.
- Thyroidectomy remained overall safe in older patients, supporting its use with appropriate risk assessment and counseling.
- All included studies were observational, and heterogeneity and unmeasured factors (eg, comorbidities, frailty, surgical complexity) may influence outcomes.
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