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Background The American Thyroid Association supports same-day thyroid surgery (SDT) in select patients. In practice, it is common for thyroid surgeons to monitor patients overnight for postoperative complications such as cervical hematoma, recurrent laryngeal nerve injury (RLN) and symptomatic hypocalcemia. We sought to determine the safety profile and predictive factors of adverse postoperative outcomes for SDT based on the experience of three large institutions. Methods A retrospective cohort study was conducted for all thyroidectomies performed at three McGill University tertiary and quaternary care centers in Montreal, Canada between January 1st, 2016 and November 13th, 2020. Patient characteristics were associated with outcomes by bivariate and multivariate analyses. Results A total of 2297 records were surveyed and 1983 patients (1513 females, 470 males) met the inclusion criteria. Amongst them, 603 (30.4%) patients were discharged the same day. The overall postoperative complication rate amongst SDT was 3.6% compared with 10.7% for inpatients (p p = 0.061). RLN injury occurred in 7 SDT (1.2%), compared with 35 (2.5%) inpatients (p = 0.050). Symptomatic hypocalcemia occurred in 3 SDT (0.5%) compared with 73 (5.3%) inpatients (p p p p = 0.041) and reoperation (p = 0.037) rates compared with the inpatient group. Conclusion This study demonstrates that SDT are safe in a select group of patients under the care of experienced thyroid surgeons at high volume thyroid surgery centers. SDT can also lead to significant cost savings in a publicly funded health care system. Further exploration is needed to clarify patient profiles most amenable to SDT and inform clinical decision-making. |
