Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery : a nested case-control study
(2019) In Langenbeck's Archives of Surgery 404(7). p.815-823- Abstract
Purpose: Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidectomy. This study aimed to investigate this issue using a national population-based register. Material and method: A nested case-control study on patients registered in the Swedish national register for endocrine surgery (SQRTPA) was performed. Patients with postoperative bleeding were matched 1:1 by age and gender to controls. Additional information on cases and controls was obtained from attending surgeons using a questionnaire. Risk factors... (More)
Purpose: Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidectomy. This study aimed to investigate this issue using a national population-based register. Material and method: A nested case-control study on patients registered in the Swedish national register for endocrine surgery (SQRTPA) was performed. Patients with postoperative bleeding were matched 1:1 by age and gender to controls. Additional information on cases and controls was obtained from attending surgeons using a questionnaire. Risk factors for postoperative bleeding were evaluated with logistic regression and are presented as odds ratios (ORs) with 95% confidence intervals (CIs). The time of bleeding in relation to surgery was also investigated. Results: There were 9494 operations, and 174 (1.8%) of them involved postoperative bleeding. In the whole cohort, patients with postoperative bleeding were older, 58 (46–69) vs. 49 (37–62) years, than patients without, p < 0.01. Male patients had a higher risk of bleeding, OR 2.18 (95% CI 1.58–2.99). In the case-control cohort, drain was an independent risk factor for bleeding, OR 1.64 (1.05–2.57). Two-thirds of patients bled within 6 h after surgery. The incidence of bleeding after 24 h was 10%. Conclusion: High age, male gender, and drain are independent risk factors for bleeding after thyroid surgery. Even with careful patient selection, prolonged observation might be necessary in thyroid surgery.
(Less)
- author
- Salem, Farhad Allahyar LU ; Bergenfelz, A. LU ; Nordenström, E. LU ; Dahlberg, J. ; Hessman, O. ; Lundgren, C. I. and Almquist, M. LU
- organization
- publishing date
- 2019-11-18
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Postoperative bleeding, Postoperative neck hematoma, risk factors, Thyroid surgery
- in
- Langenbeck's Archives of Surgery
- volume
- 404
- issue
- 7
- pages
- 815 - 823
- publisher
- Springer
- external identifiers
-
- scopus:85075369399
- pmid:31741031
- ISSN
- 1435-2443
- DOI
- 10.1007/s00423-019-01836-4
- language
- English
- LU publication?
- yes
- id
- 64ecb72c-0a51-47f2-91b0-2aa96dbfb5e9
- date added to LUP
- 2019-12-10 12:13:45
- date last changed
- 2024-04-17 00:49:33
@article{64ecb72c-0a51-47f2-91b0-2aa96dbfb5e9,
abstract = {{<p>Purpose: Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidectomy. This study aimed to investigate this issue using a national population-based register. Material and method: A nested case-control study on patients registered in the Swedish national register for endocrine surgery (SQRTPA) was performed. Patients with postoperative bleeding were matched 1:1 by age and gender to controls. Additional information on cases and controls was obtained from attending surgeons using a questionnaire. Risk factors for postoperative bleeding were evaluated with logistic regression and are presented as odds ratios (ORs) with 95% confidence intervals (CIs). The time of bleeding in relation to surgery was also investigated. Results: There were 9494 operations, and 174 (1.8%) of them involved postoperative bleeding. In the whole cohort, patients with postoperative bleeding were older, 58 (46–69) vs. 49 (37–62) years, than patients without, p < 0.01. Male patients had a higher risk of bleeding, OR 2.18 (95% CI 1.58–2.99). In the case-control cohort, drain was an independent risk factor for bleeding, OR 1.64 (1.05–2.57). Two-thirds of patients bled within 6 h after surgery. The incidence of bleeding after 24 h was 10%. Conclusion: High age, male gender, and drain are independent risk factors for bleeding after thyroid surgery. Even with careful patient selection, prolonged observation might be necessary in thyroid surgery.</p>}},
author = {{Salem, Farhad Allahyar and Bergenfelz, A. and Nordenström, E. and Dahlberg, J. and Hessman, O. and Lundgren, C. I. and Almquist, M.}},
issn = {{1435-2443}},
keywords = {{Postoperative bleeding; Postoperative neck hematoma, risk factors; Thyroid surgery}},
language = {{eng}},
month = {{11}},
number = {{7}},
pages = {{815--823}},
publisher = {{Springer}},
series = {{Langenbeck's Archives of Surgery}},
title = {{Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery : a nested case-control study}},
url = {{http://dx.doi.org/10.1007/s00423-019-01836-4}},
doi = {{10.1007/s00423-019-01836-4}},
volume = {{404}},
year = {{2019}},
}