Cross-sectional study and clinical prediction of post-thyroidectomy discomfort

Thyroid lobectomy may result in various postoperative adverse symptoms, which are closely associated with patient satisfaction and recovery outcomes. The aim of this study was to investigate the incidence of discomfort symptoms in postoperative patients following thyroid lobectomy and to develop a predictive model for early identification of patients at high risk of postoperative pain and vomiting, which would be helpful in implementing preventive management.

We enrolled a total of 532 patients hospitalised for thyroid lobectomy under general anaesthesia between October 2024 and March 2025, and assessed patients' postoperative discomfort symptoms by means of a questionnaire. Risk factors were identified by multivariate logistic regression and nomograms were created, followed by performance assessment and clinical utility assessment of nomograms.

The most common complications after thyroidectomy include pain in the incision, pharyngeal symptoms (sore throat, dysphagia, cough, etc.) and sleep disturbance. The postoperative pain frequency prediction model incorporated five correlates: thyroxine (T4), thyroglobulin antibody (TGAb), lymph node metastasis, age, and body mass index (BMI), the postoperative pain level prediction model incorporated three correlates: thyroid peroxidase antibody (TPOAb), BMI, and nodal benign or malignant status, and the postoperative vomiting prediction model incorporated four correlates: TGAb, sex, nodal diameter, and nalbuphine use.

The established nomogram may help accurately identify high-risk patients for post-thyroidectomy pain and postoperative nausea and vomiting (PONV), facilitating the timely provision of personalized pain and vomiting management strategies.