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Association Between Preexisting Thyroid Disorders and Immediate Postoperative Neurological Complications after
Sergio A Calero Martinez1, Nazeer Aboud2, Nicola Rifino3
1Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Instituto de Neurociencias, Faculty of Medicine, El Bosque University, Bogotá, Colombia.
Background:
Postoperative neurological complications remain a relevant concern after superficial temporal artery-middle cerebral artery (STA-MCA) bypass in patients with moyamoya disease. While disease-related factors have been widely studied, the impact of preexisting medical conditions on immediate postoperative outcomes is less clear.
Objective:
To evaluate whether previous diseases, chronic conditions, and psychiatric disorders are associated with postoperative neurological complications after STA-MCA bypass in adult moyamoya patients.
Methods:
We conducted a retrospective analysis of consecutive adult patients undergoing STA-MCA bypass at the Istituto Neurologico Carlo Besta between 2005 and 2023. Demographic variables and comorbidities were analyzed. The primary outcome was postoperative neurological complications during the in-hospital period. Group comparisons were performed using Mann-Whitney U and chi-square tests. A Firth logistic regression model was used to identify independent predictors.
Results:
Fifty-three patients were included, of whom 12 (23%) developed postoperative neurological complications. Thyroid disorders were present in 11 patients (21%) and were significantly associated with complications (46% vs. 17%, P = 0.042). No other comorbidities showed significant associations. In Firth regression analysis, thyroid disorder remained associated with complications (OR 5.15, P = 0.040), while age showed a modest effect (OR 1.05, P = 0.004).
Conclusions:
In our single-center experience, preexisting thyroid disorders were associated with a higher frequency of immediate postoperative neurological complications after STA-MCA bypass. Given the retrospective design and limited sample size, these findings should be considered exploratory and hypothesis-generating. Further studies are needed to validate this association.
