Postoperative Systolic Blood Pressure as a risk factor for haematoma following thyroid surgery
Postoperative Systolic Blood Pressure as a risk factor for haematoma following thyroid surgery
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DOI：
10.1111/coa.12407
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发表时间：
2015-10-01
影响因子：
2.1
通讯作者：
Vandal, Alain C.
中科院分区：
文献类型：
--
作者：
Morton, Randall P.;Vandal, Alain C.
目的探讨甲状腺手术后血肿发生的可能预测因素，特别是术后收缩压。设计回顾性分析，对接受甲状腺手术的患者进行观察性病例对照研究。设置二级综合医院。参与者2002年至2012年期间参加县曼努考区卫生委员会（CMDHB）的患者。结果术后血肿发生率为2.57%（16/621）。3名患者立即出血（即伤口闭合后但仍在手术台上）; 10名患者（1.6%）在术后早期出血;另外3名患者在术后24小时或更长时间出血。术后出血的主要独立危险因素是术后收缩压水平。在我们的患者人群中，最高血压记录每升高10个点，出血风险增加39%（OR 1.39; 95%CI = 1.09 - 1.8）。结论本研究确定术后高血压与术后早期血肿的发生显著相关。甲状腺切除术后晚期出血的原因仍然是推测性的。
Objectives To examine potential factors that may predict development of postoperative haematoma following thyroid surgery, with particular attention to postoperative systolic blood pressure.Design Retrospective, observational case-control study of patients undergoing thyroid surgery.Setting Secondary General Hospital.Participants Patients attending Counties Manukau District Health Board (CMDHB) between 2002 and 2012.Main Outcome Measures Post-operative Haematoma formation that required re-exploration of the wound.Results The overall rate of postoperative haematoma was 2.57% (16/621). Three patients bled immediately (i.e. after wound closure but while still on the operating table); 10 patients (1.6%) bled in the early postoperative period; and three others bled 24h or more after surgery. The principal independent risk factor for postoperative haemorrhage that remained after multivariable regression was postoperative systolic blood pressure level. There was a 39% increase in risk of bleeding for every 10 points rise of highest blood pressure recordings in our patient population (OR 1.39; 95% CI=1.09-1.8).Conclusions This study identifies postoperative hypertension as significantly related to development of early postoperative haematoma. Cause for late post-thyroidectomy bleeding remains speculative.