Safety of thyroidectomy in hospitalized patients: A descriptive analysis of the NSQIP thyroidectomy-targeted data - 06/08/24

Doi : 10.1016/j.amjsurg.2024.115854

George A. Taylor ^a, Rebecca L. Green ^a, Swathi Raman ^b, Sarah M. Kling ^a, Alexander M. Fagenson ^c, Huaqing Zhao ^b, Lindsay E. Kuo ^a,^b,^⁎
^a Department of Surgery, Temple University Hospital, Philadelphia, PA, 19140, USA
^b Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 19140, USA
^c Division of Transplant Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

^⁎Corresponding author. Department of Surgery, Lewis Katz School of Medicine Temple University Hospital, 3401 N Broad Street, Parkinson Pavilion Zone C, 4th Floor, Philadelphia, PA, 19140, USA.Department of SurgeryLewis Katz School of Medicine Temple University Hospital3401 N Broad StreetParkinson Pavilion Zone C4th FloorPhiladelphiaPA19140USA

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 06 August 2024

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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Highlights

•	Thyroidectomy on inpatients carries an increased risk of complications compared to outpatients.
•	Admission for any reason prior to thyroidectomy independently increases complication risk.
•	Postoperative resource utilization for already admitted thyroidectomy patients is high.
•	Patients requiring thyroidectomy while hospitalized should be counseled accordingly.

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Keywords : Admitted thyroidectomy, Inpatient, Outpatient, Recurrent laryngeal