Association of preoperative thyroid hormone replacement with perioperative complications after major abdominal surgery - 11/05/24
Abstract |
Objective |
To determine the association between preoperative thyroid hormone replacement and complications following major abdominal surgery.
Methods |
A retrospective case series was performed of patients enrolled in the Michigan Surgical Quality Collaborative (MSQC) who underwent major abdominal surgery at an academic institution over a 10-year period. The principal explanatory variable was preoperative thyroid hormone replacement. Primary outcomes were morbidity, mortality and length of stay.
Results |
2700 patients were identified. On multivariate analysis correcting for established predictors of operative morbidity, patients on preoperative thyroid replacement had a 1.5- fold increased risk of serious morbidity(p = 0.01), and a 1.7- fold greater risk for serious sepsis(p = 0.04). Thyroid replacement was associated with longer length of stay(p < 0.001). While there was a high degree of missing data for surgical approach (31.1 % missing data), results suggest that patients on thyroid hormone replacement were more likely to undergo an open rather than minimally invasive surgery(p < 0.01). Open surgery was associated with greater risk of serious morbidity(p = 0.003) and longer length of stay(p < 0.001).
Conclusions |
Preoperative thyroid hormone replacement independently predicts operative morbidity and length of stay following major abdominal surgery.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The relationship between hypothyroidism and complications following major abdominal surgery has not been elucidated. |
• | Patients with pre-existing hypothyroidism have significantly increased morbidity and length of stay. |
• | There are opportunities for perioperative optimization and risk stratification based on thyroid replacement. |
Plan
Vol 232
P. 107-111 - juin 2024 Retour au numéro
Article précédent
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