Safety of thyroidectomy in hospitalized patients: A descriptive analysis of the NSQIP thyroidectomy-targeted data

IF 2.3 3区 医学 Q1 SURGERY American journal of surgery Pub Date : 2025-02-01 Epub Date: 2024-07-19 DOI:10.1016/j.amjsurg.2024.115854
George A. Taylor , Rebecca L. Green , Swathi Raman , Sarah M. Kling , Alexander M. Fagenson , Huaqing Zhao , Lindsay E. Kuo
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Abstract

Background

Some patients undergo thyroidectomy while hospitalized for a related or independent indication. Outcomes have not been described in this group.

Methods

The 2016–2018 thyroidectomy-targeted NSQIP datasets were queried for patients admitted for ≥1 day preoperatively. 1:1 propensity score matching was employed to compare the outcomes of admitted patients to outpatients, including surgical and thyroidectomy-specific outcomes. Multivariable logistic regression determined factors associated with poor outcomes.

Results

Of 18,078 patients, 312 were admitted at least 1 day prior to surgery. Inpatients had higher ASA classifications and rates of several comorbidities compared to the general population. After propensity score matching, inpatients had higher rates of overall complications, unplanned reoperation, and bleeding. They also experienced higher rates of thyroidectomy-specific complications such as hypocalcemia and neck hematoma. By multivariable regression, admission prior to surgery was associated with development of any complications.

Conclusion

Thyroidectomy in hospitalized patients carries an increased risk of complications. Patients requiring thyroidectomy while already hospitalized should be counseled accordingly.
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住院患者甲状腺切除术的安全性:NSQIP 甲状腺切除术目标数据的描述性分析
背景:一些患者在住院期间因相关或独立适应症行甲状腺切除术。本组结果未见描述。方法对术前住院≥1天的2016-2018年甲状腺切除术NSQIP数据集进行查询。采用1:1倾向评分匹配来比较住院患者和门诊患者的结局,包括手术和甲状腺切除术特异性结局。多变量逻辑回归确定了与不良结果相关的因素。结果18078例患者中,312例至少在手术前1天入院。与一般人群相比,住院患者有更高的ASA分类和几种合并症的发生率。倾向评分匹配后,住院患者的总体并发症、计划外再手术和出血发生率较高。他们也经历了更高的甲状腺切除术特异性并发症,如低钙血症和颈部血肿。通过多变量回归,手术前入院与任何并发症的发生有关。结论住院患者行甲状腺切除术发生并发症的风险增高。已经住院但需要甲状腺切除术的患者应给予相应的建议。
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来源期刊
CiteScore
5.00
自引率
6.70%
发文量
570
审稿时长
56 days
期刊介绍: The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.
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