Resource utilization associated with cervical hematoma after thyroid and parathyroid surgery.

Area of Science:

• Endocrinology
• Surgical Oncology
• Health Services Research

Background:

• Postoperative cervical hematoma (PCH) is a known complication following thyroid and parathyroid surgery.
• This study investigates the impact of PCH on patient outcomes and healthcare resource utilization.

Purpose of the Study:

• To identify risk factors associated with PCH after thyroid and parathyroid procedures.
• To estimate the impact of PCH on mortality, length of stay (LOS), and total costs.

Main Methods:

• Utilized data from the Nationwide Inpatient Sample (NIS) for patients undergoing thyroid or parathyroid surgery (2001-2011).
• Employed multivariable logistic regression to identify risk factors for PCH.
• Applied linear regression models to assess the effect of PCH on LOS and costs, adjusting for covariates.

Main Results:

• PCH occurred in 0.8% of patients (619 cases).
• Risk factors included nonelective admission, Graves' disease, other benign pathology, and multiple comorbidities.
• PCH was associated with a 2.1-day increase in LOS, $7316 in excess costs, and more than tripled the odds of mortality.

Conclusions:

• Preoperative patient risk factors significantly influence the risk of PCH.
• Clinicians can use risk stratification to potentially minimize resource utilization and healthcare spending in high-risk patients.