Key result
Post-operative systolic blood pressure ≥180 mmHg (p=0.003), diabetes, and high drain output were identified as independent risk factors for post-operative bleeding after thyroidectomy.
Why the study?
What are the risk factors for post-operative bleeding in patients undergoing thyroidectomy?
Cohort (n=205)
No
What are the risk factors for post-operative bleeding in patients undergoing thyroidectomy?
p-value: p=0.003
Post-operative hypertension, diabetes, and high drain output are independent risk factors for post-thyroidectomy bleeding, suggesting caution for same-day discharge in these patients.
May warrant closer monitoring after thyroidectomy in high-risk patients; Level 3 data leaves open prospective validation before practice change.
BACKGROUND: There has been increasing emphasis on performing 'same-day' or 'out-patient' thyroidectomy to reduce associated costs. However, acceptance has been limited by the risk of potentially life-threatening post-operative bleeding. This study aimed to review current rates of post-operative bleeding in a metropolitan teaching hospital and identify risk factors. METHOD: Medical records of patients undergoing thyroidectomy between January 2007 and March 2012 were reviewed retrospectively. Pre-operative, operative and pathological data, and post-operative complication data, were examined. RESULTS: The study comprised 205 thyroidectomy cases. Mean age was 51.6 years (standard deviation = 14.74), with 80 per cent females. Unilateral thyroidectomy was performed in 81 cases (39.5 per cent) and total thyroidectomy was performed in 74 cases (36.1 per cent; 5.3 per cent with concomitant lymph node dissection). Nine patients (4.4 per cent) suffered post-operative bleeding, of which six required re-operation. Analysis showed that post-operative systolic blood pressure of 180 mmHg or greater was associated with post-operative bleeding (p = 0.003, chi-square test). CONCLUSION: Rates of significant post-operative bleeding are consistent with recent literature. Post-operative hypertension, diabetes and high post-operative drain output were identified as independent risk factors on multivariate analysis; when identified, these may be caveats to same-day discharge of thyroidectomy patients.
No takes yet. Share an insight, caveat, or question.
Perera et al. (2015) conducted a cohort in Patients undergoing thyroidectomy (n=205). Post-operative systolic blood pressure ≥180 mmHg, diabetes, and high drain output vs. Absence of these risk factors was evaluated on Post-operative bleeding (p=0.003). Post-operative systolic blood pressure ≥180 mmHg (p=0.003), diabetes, and high drain output were identified as independent risk factors for post-operative bleeding after thyroidectomy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: