Outcomes of thyroidectomy from a large California state database.

Autor: Weiss A; Department of Surgery, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0987, USA., Parina RP; Department of Surgery, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0987, USA., Tang JA; Department of Surgery, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0987, USA., Brumund KT; Department of Surgery, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0987, USA., Chang DC; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Bouvet M; Department of Surgery, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0987, USA. Electronic address: mbouvet@ucsd.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2015 Dec; Vol. 210 (6), pp. 1170-6; discussion 1176-7. Date of Electronic Publication: 2015 Sep 28.
DOI: 10.1016/j.amjsurg.2015.08.011
Abstrakt: Background: Thyroidectomy is an operation with infrequent but potentially significant complications. This study aimed to determine risk factors for complication after thyroidectomy in California.
Methods: The California Office of Statewide Health Planning and Development database was retrospectively analyzed from 1995 to 2010. Main outcome measures were complications including death. Logistic regression identified risk factors for complications.
Results: There were 106,773 patients; 61% were women and 44% Caucasian; 16,287 (15%) thyroidectomies were performed at high-volume centers. Complication rates included voice change (.5%), vocal cord dysfunction (1.1%), hypocalcemia (4.5%), tracheostomy (1.62%), hematoma (1.75%), and death (.3%). There was significantly increased risk of complications for patients older than 65 compared with those younger than 40 years (odds ratio, 2.0; 95% confidence interval, 1.8 to 2.3; P < .01). High-volume hospitals were protective against complication (odds ratio, .8; 95% confidence interval, .6 to .97; P = .026).
Conclusions: Older age was a significant risk factor for complication after thyroidectomy. High-volume hospitals had lower risk. This information is useful in counseling patients about the risks of thyroid surgery.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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