Why the study?
Urinary tract infections represent a rare postoperative complication after thyroidectomy, but clinicodemographic risk factors and associated outcomes remained to be determined.
What are the risk factors for and outcomes associated with postoperative urinary tract infections in patients undergoing thyroidectomy?
What are the risk factors for and outcomes associated with postoperative urinary tract infections in patients undergoing thyroidectomy?
Postoperative UTIs following thyroidectomy are rare (0.28%) but are associated with significantly increased risks of severe postoperative complications and prolonged hospital stays.
Postoperative UTI signals higher complication risk after thyroidectomy; leaves open whether prevention reduces events in prospective trials.
Introduction Urinary tract infections (UTIs) represent a rare postoperative complication following thyroidectomy. Objective This study aimed to assess the clinicodemographic factors associated with the development of UTIs and subsequent outcomes among patients undergoing thyroidectomy. Methods This retrospective study used the National Surgical Quality Improvement Program (NSQIP) database to analyze patients who underwent thyroidectomy from 2005 to 2019. Multivariable logistic regression models were used to identify risk factors and associations of UTIs with postoperative morbidity and mortality. Results In a cohort of 180,373 identified thyroidectomy patients, 0.28% contracted a UTI. Significant risk factors associated with UTIs included age > 60 years (adjusted odds ratio [OR] 2.187, 95% confidence interval [CI] 1.618–2.956), female gender (OR 1.767, 95% CI 1.372–2.278), American Society of Anesthesiologists (ASA) Classification 3 to 5 (OR 1.463, 95% CI 1.185–1.805), partially (OR 4.267, 95% CI 2.510–7.253) or totally dependent functional health status (OR 9.658, 95% CI 4.170–22.370), pulmonary disease (OR1.907, 95% CI 1.295–2.808), chronic steroid therapy (OR 1.649, 95% CI 1.076–2.527), inpatient procedure (OR 1.507, 95% CI 1.251–1.814), and operative time > 150 minutes (OR 1.449, 95% CI 1.027–2.044). Additionally, UTIs were independently associated with postoperative complications, including pulmonary, vascular, or cardiac complication; stroke; acute renal failure; infectious complications; sepsis; septic shock; pneumonia; prolonged length of stay; unplanned reoperation; and mortality. Conclusion While UTIs are rare after thyroidectomy, they carry a significant burden on patient outcomes. Preoperative optimization of comorbidities and reducing operative times may help mitigate the risk of UTIs. Optimized care for postoperative UTI patients is also recommended to prevent complications and improve outcomes.
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Waqar et al. (2025) studied this question.
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