Post-thyroidectomy emergency room visits and readmissions: Assessment from the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP) - 27/09/20

Doi : 10.1016/j.amjsurg.2020.02.036

Aida Taye ^a,^⁎ , William B. Inabnet ^b , Stephanie Pan ^c , Sally E. Carty ^d , Travis Cotton ^e , Peter Czako ^f , Gerard Doherty ^g , Paul Gauger ^h , John Hanks ⁱ , David McAneny ^j , Mira Milas ^k , Nancy Perrier ^l , Jennifer Rosen ^m , David F. Schneider ⁿ , Jyotirmay Sharma ^o , Allan Siperstein ^p , Julie Ann Sosa ^q
^a Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
^b Department of Surgery, University of Kentucky, Lexington, KY, USA
^c Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
^d Department of Surgery, University of Pittsburgh School of Medicine at University of Pittsburgh Medical Center, Pittsburgh, PA, USA
^e Department of Surgery, Brown University Warren Alpert School of Medicine at University Surgical Associates, Providence, RI, USA
^f Department of Surgery, Oakland University William Beaumont School of Medicine at Royal Oak Surgical Associates, Royal Oak, MI, USA
^g Department of Surgery, Harvard Medical School at Brigham and Women’s Hospital, Boston, MA, USA
^h Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA
ⁱ Department of Surgery, University of Virginia School of Medicine at University of Virginia Health Systems, Charlottesville, VA, USA
^j Department of Surgery, Boston University School of Medicine at Boston Medical Center, Boston, MA, USA
^k Department of Surgery, University of Arizona College of Medicine at Banner-University Medical Center, Phoenix, AZ, USA
^l Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
^m Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA
ⁿ Department of Surgery, University of Wisconsin School of Medicine, Madison, WI, USA
^o Department of Surgery, Emory University School of Medicine at Emory University Hospital, Atlanta, USA
^p Department of Surgery, Cleveland Clinic, Cleveland, OH, USA
^q Department of Surgery, University of California San Francisco-UCSF, San Francisco, CA, USA

^∗Corresponding author. Icahn School of Medicine at Mount Sinai, Department of Surgical Oncology, Mount Sinai West & St. Luke’s Hospital, 425 West 59th Street, 7th Floor, New York, NY, 10019, USA.Icahn School of Medicine at Mount SinaiDepartment of Surgical OncologyMount Sinai West & St. Luke’s Hospital425 West 59th Street7th FloorNew YorkNY10019USA

Abstract

Background

This study analyzed independent factors associated with post-thyroidectomy Emergency Room (ER) visits and Hospital Readmissions (HR).

Methods

This is a retrospective review from the CESQIP registry of 8381 thyroidectomy patients by 173 surgeons at 46 institutions. A total of 7142 ER visits and 7265 HR were analyzed. Multivariable logistic regression analysis was performed to determine the risk factors for an ER visit or HR.

Results

Within 30-days of surgery, rates of all ER visits were 3.4% (n = 250) and all HR were 2.3% (n = 170). Hypocalcemia was the reason for 21.9% of ER encounters and 36.4% of HR. BMI >40 kg/m² was a risk factor for both ER visit (OR1.86) and HR (OR1.94). Surgical duration >3 h (OR2.63), and transection of recurrent laryngeal nerve (OR4.58) were risk factors for HR.

Conclusions

Strategies to decrease hypocalcemia and improve perioperative care of patients with BMI >40 kg/m² may improve post-thyroidectomy outcome.

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Highlights

•	Hypocalcemia was the most common reason for post-thyroidectomy related complication.
•	Minor complaints or complaints unrelated to thyroidectomy made up half of the reasons for ER visits.
•	Complications of swelling/seroma, infection, respiratory distress and neck hematoma are rare.
•	Patient BMI >40 kg/m² is a risk factor for ER visit and hospital readmission after thyroidectomy.

Le texte complet de cet article est disponible en PDF.

Keywords : Thyroidectomy, Emergency room visits, Readmissions, Outcomes, Quality

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Vol 220 - N° 4

P. 813-820 - octobre 2020 Retour au numéro

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Post-thyroidectomy emergency room visits and readmissions: Assessment from the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP) - 27/09/20

Abstract

Background

Methods

Results

Conclusions

Highlights

Plan

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