Risk factors for postoperative complications in total thyroidectomy A retrospective, risk-adjusted analysis from the National Surgical Quality Improvement Program
Risk factors for postoperative complications in total thyroidectomy A retrospective, risk-adjusted analysis from the National Surgical Quality Improvement Program
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DOI：
10.1097/md.0000000000005752
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发表时间：
2017-02-01
期刊：
影响因子：
1.6
通讯作者：
Javidnia, Hedyeh
中科院分区：
文献类型：
--
作者：
Caulley, Lisa;Johnson-Obaseki, Stephanie;Javidnia, Hedyeh
甲状腺癌的发病率正在增加，甲状腺全切除术也随之增加。比较住院与门诊进行甲状腺全切除术的结果的研究有限。本研究的目的是对住院与门诊进行甲状腺全切除术的风险因素以及术后发病率和死亡率的结果进行比较分析。回顾性队列研究2005年至2014年多机构、美国外科医师学会国家外科质量改进计划（ACS-NSQIP）数据库。采用多变量回归模型及相应的比值比和95%置信区间来确定甲状腺全切除术后30天的发病率和死亡率，以及术后结局的风险因素。从2005年至2014年，共进行了40，025例甲状腺全切除术（48.5%住院，51.5%门诊）。所有甲状腺全切除术的30天并发症发生率为7.74%。进行多变量logistic回归分析以控制潜在的混杂变量。影响住院甲状腺切除术并发症发生率的术前因素包括：年龄>= 70岁，非白种人，依赖性功能状态，充血性心力衰竭史，吸烟史，出血性疾病，伤口感染和术前脓毒症（P
Thyroid cancer incidence is increasing, and with it, an increase in total thyroidectomy. There are limited studies comparing outcomes in total thyroidectomy performed in the inpatient versus outpatient setting.The objective of this study was to perform a comparative analysis of risk factors and outcomes of postoperative morbidity and mortality in total thyroidectomy performed as an inpatient versus outpatient surgery.Retrospective cohort study of data from the 2005 to 2014 multi-institutional, risk-adjusted American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. A multivariate regression model with corresponding odds ratios and 95% confidence intervals was used to determine 30-day morbidity and mortality after total thyroidectomies, and also risk factors of postoperative outcomes.From 2005 to 2014, 40,025 total thyroidectomies were performed (48.5% inpatient, 51.5% outpatient). The 30-day complication rate for all total thyroidectomies was 7.74%. Multivariate logistic regression analysis was performed to control for potential confounding variables. Preoperative factors that affected complications rates for inpatient thyroidectomies included: age >= 70, non-Caucasian race, dependent functional status, history of congestive heart failure, smoking history, bleeding disorder, wound infection, and preoperative sepsis (P