caa a22 4500 445338970 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1938-2 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1938-2 Medical and Surgical Risks in Thyroid Surgery: Lessons from the NSQIP [Elektronische Daten] [Melanie Goldfarb, Zvi Perry, Richard A. Hodin, Sareh Parangi] Background: To assess whether perioperative surgical outcomes associated with thyroid operations were different in those with benign or malignant conditions, we queried the NSQIP, a multi-institutional, risk-adjusted, prospective U.S. database. Methods: A total of 10,838 patients who underwent initial thyroid surgery as their principal operation during 2005-2007 were analyzed. Analysis focused on demographics, preoperative risk factors, operative details, postoperative complications, return to the operating room, and length of surgical stay. Results: Thirty-three percent of patients had a postoperative diagnosis of malignancy. Mean operating time was 121.8min (119.3min benign, 123.0min malignant, P=.004) and average length of stay 1.16days (1.12days benign, vs. 1.21days malignant, P=.007). Overall morbidity (return to the operating room plus medical complications) was 3.8% for the entire cohort, significantly higher in patients with malignant disease (4.9 vs. 3.3%, respectively, P<.001). On multivariate analysis, American Society of Anesthesiologists class, congestive heart failure (odds ratio [OR] 6.83, 95% confidence interval [CI] 1.81-25.80), dyspnea, and return to the operating room (OR 5.41, 95% CI 3.1-9.45) were significant risk factors for complications, while malignant disease (OR 2.25, 95% CI 1.75-2.9), outpatient status (OR 3.16, 95% CI 2.4-4.17), and other complications (OR 6.46, 95% CI 3.61-11.54) were risk factors for returning to the operating room. Conclusions: Patients undergoing thyroid surgery for malignancy have a longer length of stay (1.21days), longer operation times, and return to the operating room at higher rates compared to those with benign disease. Malignancy itself is only an independent risk factor for return to the operating room and not other complications; surgeons may consider keeping those patients overnight for observation. Society of Surgical Oncology, 2011 Goldfarb Melanie Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA aut Perry Zvi Surgical Research Lab, Tufts Medical Center, Boston, MA, USA aut A. Hodin Richard Department of Endocrine Surgery, Thyroid Cancer Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA aut Parangi Sareh Department of Endocrine Surgery, Thyroid Cancer Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3551-3558 1068-9265 18:13<3551 2011 18 10434 https://doi.org/10.1245/s10434-011-1938-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1938-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Goldfarb Melanie Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Perry Zvi Surgical Research Lab, Tufts Medical Center, Boston, MA, USA aut NATIONALLICENCE 700 1- A. Hodin Richard Department of Endocrine Surgery, Thyroid Cancer Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Parangi Sareh Department of Endocrine Surgery, Thyroid Cancer Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3551-3558 1068-9265 18:13<3551 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer