Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery: a nested
Farhad Allahyar Salem1, A Bergenfelz2, E Nordenström2
1Department of Clinical Sciences, Lund University, Lund, Sweden. farhad.salem@med.lu.se.
Langenbeck'S Archives of Surgery
|November 20, 2019
Summary
Postoperative bleeding after thyroid surgery is a risk. Older age, male gender, and surgical drains increase bleeding risk. Careful patient selection and observation are crucial for outpatient thyroidectomy safety.
Area of Science:
- Endocrine Surgery
- Surgical Complications
- Patient Safety
Background:
- Postoperative bleeding is a serious complication following thyroid surgery.
- Outpatient thyroidectomy is becoming more common, necessitating risk factor identification.
- Understanding risk factors is key for selecting appropriate candidates for same-day discharge.
Purpose of the Study:
- To identify independent risk factors for postoperative bleeding after thyroid surgery.
- To evaluate patient characteristics and surgical factors associated with bleeding.
- To inform patient selection for outpatient thyroidectomy.
Main Methods:
- A nested case-control study using the Swedish national register for endocrine surgery (SQRTPA).
- 174 bleeding cases were matched 1:1 with controls by age and gender.
- Logistic regression analysis was used to determine risk factors (ORs with 95% CIs).
Main Results:
- 1.8% (174/9494) of thyroidectomies resulted in postoperative bleeding.
- Older age (58 vs 49 years) and male gender (OR 2.18) were significant risk factors for bleeding.
- Surgical drain use (OR 1.64) was an independent risk factor; two-thirds of bleeding occurred within 6 hours post-surgery.
Conclusions:
- Advanced age, male gender, and the use of surgical drains are independent risk factors for postoperative bleeding.
- These findings highlight the need for careful patient selection and potentially prolonged observation, even in outpatient thyroidectomy settings.
