Complications and indications for intensive care unit admission after thyroidectomy in a University Teaching Hospital

Routine admission of all post-thyroidectomy patients into intensive care unit (ICU) within the first 24-48 hours is advocated and practised in some hospitals. However, clinicians today are faced with the need to improve patient outcome at minimal costs.

To determine the incidence of life-threatening complications necessitating (ICU) admission following thyroidectomy; and to identify any pre-operative risk factors for ICU admission in patients with goitre.

University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Retrospective study.

A retrospective study of all patients who were admitted to the ICU following thyroidectomy, over a period of 10 years (January 1993- December 2002), was carried out. Their records were analysed for indication for admission, therapeutic intervention instituted and outcome.

A total of 196 case notes out of the 210 thyroidectomies performed within the study period could be retrieved for analysis. Twenty patients (10.2%) required ICU admission for various indications. Sixteen of the admissions were elective based on recognition of the need immediately after extubation in the theatre, while the remaining 4 patients were emergency admissions transferred from the post-surgical ward at variable periods within the first 24-hours post-operatively. The most common reason for ICU admission was recurrent laryngeal nerve (RLN) palsy, which occurred in 13 patients (6.6%). There was one mortality in the elective admissions and no mortality in emergency admissions. No patient died or suffered disability on account of failure to get admitted to ICU.

It is safe to discharge the majority of patients back to post-surgical ward for nursing care immediately after thyroidectomy. Most of our patients were discharged to the post-surgical ward without any life-threatening complication.