Dependent status is a risk factor for complications after thyroidectomy

Abstract

Background: Functional dependency has been associated with increased risk of adverse events following many surgical procedures. We hypothesized that dependent patients would have an increased risk of complications following thyroidectomy.

Methods: We performed a retrospective review of total thyroidectomies performed from 1/2012-12/2019 as identified by CPT codes using the National Surgical Quality Improvement Project (NSQIP) database. Functional dependent status was identified from within the NSQIP database with partially or totally dependent combined into the dependent group.

Results: A total of 64,978 patients were included, with 0.53% identified as functionally dependent (FD). Functional dependency was associated with an increased risk of wound disruption, pneumonia, UTI, stroke, cardiac arrest, PE/DVT, and sepsis/septic shock. Dependent patients had higher rates of unplanned intubation, ventilator use, and significant bleeding. On multivariate analysis, FD patients were more likely to suffer from major complications and have an increased length of stay.

Conclusions: Dependent status was associated with an increased risk of complications following thyroidectomy. Focused preoperative and disposition planning for these patients can help to minimize adverse outcomes and optimize resource utilization.

Keywords: Functional status; Surgical outcomes; Thyroid; Thyroidectomy.