Thyroidectomy outcomes: a national perspective

Abstract

Objectives: Describe trends and outcomes of patients undergoing thyroidectomy.

Study design and setting: Retrospective search of national inpatient database.

Subjects and methods: The Nationwide Inpatient Sample 2009 was searched using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for thyroidectomy. Data extraction included patient demographics, hospital characteristics, and associated diagnoses. Subgroup analysis was performed on mortalities; bivariate and multivariate analysis was used to examine predictors of complications.

Results: In the United States, 59,478 patients were admitted and underwent thyroidectomy in 2009. Their mean (SD) age was 53.0 (16.4) years. Mean (SD) length of stay was 3.0 (6.9) days, and mean (SD) total charges was $39,236 ($73,679). Total thyroidectomy was performed in 53.6% of patients; 33.2% underwent unilateral lobectomy. Most common thyroid disorders included nontoxic nodular goiter (36.0%) and malignant neoplasm (30.3%). There were 363 (0.61%) mortalities, with a mean (SD) age of 65.5 (15.2) years, length of stay of 13.9 (15.2) days, and total charges of $218,855 ($191,977). Of all patients, 6.18% had hypocalcemia and 0.77% had hypoparathyroidism; the incidence of vocal cord paresis was 0.85% unilaterally and 0.34% bilaterally. Multivariate analysis revealed predictors of complications following thyroid surgery were female sex (P = .0001), total thyroidectomy procedure (P < .0001), hospital location and teaching status (P = .0060), hospital bed size (P = .0054), type of thyroid disorder, and underlying patient comorbidities.

Conclusion: Reporting of normative data for thyroidectomy facilitates comparison. Hospitalizations for patients undergoing thyroidectomy require significant resource utilization. Predictors of complications include female sex, type of thyroid disorder and procedure, hospital location and teaching status, hospital bed size, and patient comorbidities.