Risk factors for postoperative morbidity after thyroid surgery in a PROSPECTIVE cohort of 1500 patients
Adult
Male
IMPACT
HYPOPARATHYROIDISM
Hypocalcaemia
THYROIDECTOMIES
Postoperative Hemorrhage
RECURRENT LARYNGEAL NERVE
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Medicine and Health Sciences
SURGICAL VOLUME
Humans
Prospective Studies
RLN palsy
METAANALYSIS
Outcome
Aged
COMPLICATIONS
OUTCOMES
Hypocalcemia
Volume
Bleeding
General Medicine
Middle Aged
TRENDS
HYPOCALCEMIA
3. Good health
Thyroidectomy
Surgery
Female
Morbidity
Vocal Cord Paralysis
DOI:
10.1016/j.ijsu.2021.105922
Publication Date:
2021-03-25T15:56:48Z
AUTHORS (5)
ABSTRACT
Postoperative hypocalcaemia, recurrent laryngeal nerve palsy and postoperative bleeding are the most frequent postoperative complications after thyroid surgery, and therefore often used as quality indicators of thyroid surgery. We aimed to assess postoperative morbidity in a high-volume endocrine surgery unit, and to detect which factors are associated with higher risks.Prospective surgical cohort in a high-volume tertiary referral centre for endocrine surgery in xxx. The first 1500 patients operated with hemi or total thyroidectomy during 2010-2019 were included. Postoperative hypocalcaemia, recurrent laryngeal nerve palsy and postoperative bleeding were assessed in relation to pre- and peri-operative characteristics using multivariable logistic regression analyses, expressed as odds ratios and 95% confidence intervals.Overall, 1043 patients (69.5%) received a total thyroidectomy and 457 (30.5%) a hemithyroidectomy. Permanent hypocalcaemia occurred in 3.1%, permanent recurrent laryngeal nerve palsy in 1.8% and surgical reintervention for bleeding in 2.6%. Younger age, female sex and cancer were risk factors for permanent hypocalcaemia. No clear risk factors could be identified for permanent nerve palsy. Female sex, high body mass index and heavier thyroids were protective against postoperative bleeding after total thyroidectomy.Surgical experience in endocrine surgery seems beneficial for clinical outcomes and contributes to organizational efficiency. A low complication risk can be obtained by trained high-volume endocrine surgeons, yet the risk is not negligible.
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