Factors Associated with Thyroid Surgery Complications at Maharat Nakhon Ratchasima Hospital

Background: Thyroidectomy is one of the most frequently performed operations for thyroid disease. Thyroidectomy was associated with increased morbidity and even mortality. Potential major complications of thyroid surgery include bleeding (0.3-1%), injury to the RLN (4- 6.6%) if the nerve is not identified), hypoparathyroidism (2-53%), hypothyroidism (5-41.9%), thyrotoxic storm (< 0.5%), injury to superior laryngeal nerve (0-25%), and infection (1-2%). This study assessed the current understanding of factors predicting such complications following thyroidectomy. Objectives: To investigate factors associated with complications in thyroid surgery. Materials and Methods: We performed a retrospective analysis of all patients aged > 15 years who underwent thyroid surgery for any thyroid disease at our institution between October 2022 and September 2023. Data was analyzed regarding demographics, clinical features, operative details, postoperative complications, and histopathology results of tissue specimens. Results: A total of 278 patients were identified, comprising 187 females (67.26%) and 91 males (32.74%). 106 surgical complications were observed in 77 patients (27.7%). The most common complication in the study was hypocalcemia, occurring in 54 cases (19.4%). This was followed by hoarseness in 42 cases (15.1%). The final model revealed that subtotal/total thyroidectomy had a strong and significant association with complications (adjusted RR: 4.15; 95% CI: 2.63-6.55; p < 0.001). Similarly, a disease duration exceeding 10 years (adjusted RR: 1.46; 95% CI: 1.09–1.97; p = 0.012) and thyroid nodule weight exceeding 200 gm. was also statistically significant adjusted RR: 2.11; 95% CI: 1.05-4.24; p = 0.035). Conclusion: The postoperative complications of thyroid surgery were associated with the subtotal/total thyroidectomy, a disease duration exceeding 10 years, and thyroid nodule weight exceeding 200 gm. Therefore, special caution must be exercised in patients with these characteristics.