Thyroidectomy practice in pediatric population: a national perspective.

Area of Science:

• Pediatric surgery
• Endocrinology
• Health services research

Background:

• Thyroidectomy is a common surgical procedure in pediatric patients.
• Understanding the epidemiology and outcomes of pediatric thyroidectomy is crucial for optimizing patient care.
• Previous studies have not comprehensively analyzed national trends in pediatric thyroidectomy.

Purpose of the Study:

• To examine the presentations and outcomes of pediatric patients undergoing thyroidectomy.
• To identify risk factors for postoperative complications.
• To compare outcomes and costs associated with management in children's hospitals versus general hospitals.

Main Methods:

• Retrospective cross-sectional analysis of the Nationwide Readmissions Database (2010-2014).
• Inclusion of pediatric patients (<18 years) undergoing thyroidectomy.
• Analysis of patient demographics, thyroid disease types, surgical procedures, complications, and healthcare costs.

Main Results:

• A total of 361 pediatric patients were analyzed, with a mean age of 13.5 years; 79.8% were female.
• The most common indications were non-toxic benign disease (42.0%) and toxic nodular disease (33.6%).
• Hypocalcemia was the most frequent complication (98.2% of complications), with higher risk in thyroid cancer and toxic thyroid disease cases. Management in children's hospitals was associated with significantly higher costs ($19,457.50 vs. $13,788.00) without improved outcomes.

Conclusions:

• Thyroidectomy in the pediatric population is predominantly performed for benign conditions.
• A significant proportion of pediatric thyroidectomies occur at low-volume centers.
• Management in children's hospitals incurs higher costs without demonstrable benefits in outcomes or hospital stay duration.