Franklyn et al (1) undertook a population-based study describing a cohort of over 7000 patients treated with radioactive iodine over a 40 year period. The study examined data on both specific and all-cause mortality - the study compared rates with national figures for the general population for England and Wales. The findings included:
all-cause mortality was 13% higher in the radioactive iodine treated group than in the general population
excess mortality was most prominent in the first year after radioactive iodine treatment - the difference in mortality rates declined thereafter
cardiovascular and cerebrovascular disease were the major causes of excess mortality in the radioactive iodine treated group - the mortality associated with these causes was greatest in the first year after treatment - the excess mortality was seen in the over-50s age group - of note, is that hyperthyroidism is itself associated with cardiovascular problems and the excess deaths may be explained by the presence of hyperthyroidism itself, rather than radioiodine
the study also revealed an increased risk of death from thyroid disease in the radioiodine group - this was most evident in the first year after treatment and disappeared after nine years follow-up. This may be explained that the higher probability of receiving treatment with radio-iodine during the period of most severe hyperthyroidism
Reference:
1) Franklyn JA, Maisonneuve P, Sheppard MC et al (1998). Mortality after the treatment of hyperthyroidism: a population-based cohort study. NEJM, 341 (12), 879-884.
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