Smoking is associated with adverse clinical outcomes after thyroidectomy: a 5-year retrospective analysis

Tobacco use has been confirmed to be a risk factor for postoperative complications, but the impact of smoking on adverse outcomes following thyroidectomy remains largely unknown.

Using data spanning 2016-2020 from the National Inpatient Sample, patients aged ≥ 18 years who underwent thyroidectomy for thyroid malignancy or other thyroid disorders were identified and classified into two groups: current smokers and non-smokers. We compared outcome variables between the two groups via univariate analysis and adjusted multivariate logistic regression.

The present study included 13,737 records of patients who underwent thyroidectomy, among whom 1,360 (9.90%) were identified as current smokers. After propensity score matching, logistic regression analysis suggested that smoking was associated with a heightened risk of unfavorable discharge (aOR = 1.27, 95% CI [1.05-1.54], P = 0.012), vocal dysfunction (aOR = 1.25, 95% CI [1.00-1.55], P = 0.049), hypocalcemia (aOR = 1.23, 95% CI [1.05-1.44], P = 0.010), hypomagnesemia (aOR = 1.58, 95% CI [1.19-2.09], P = 0.001), and respiratory complications (aOR = 1.39, 95% CI [1.16-1.68], P < 0.001). Similar results were observed in both patients who underwent thyroidectomy for thyroid malignancy and those who underwent thyroidectomy for other thyroid disorders when a stratified analysis by surgical indications was performed.

Smoking is an independent risk factor for adverse clinical outcomes after thyroidectomy.