Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)
BackgroundPostoperative cervical haematoma represents an infrequent but potentially life-threatening complication of thyroidectomy. Since this complication is uncommon, the assessment of risk factors associated with its development is challenging. The main aim of this study was to identify the risk...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1278696/full |
| _version_ | 1797668198885097472 |
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| author | Gian Luigi Canu Fabio Medas Federico Cappellacci Leonardo Rossi Benard Gjeloshi Luca Sessa Luca Sessa Francesco Pennestrì Francesco Pennestrì Reza Djafarrian Maria Mavromati George Kotsovolis George Kotsovolis Ioannis Pliakos Ioannis Pliakos Giacomo Di Filippo Giovanni Lazzari Carla Vaccaro Martina Izzo Francesco Boi Paolo Brazzarola Francesco Feroci Francesco Feroci Marco Stefano Demarchi Theodossios Papavramidis Theodossios Papavramidis Gabriele Materazzi Marco Raffaelli Marco Raffaelli Pietro Giorgio Calò REDHOT Study Collaborative Group Giacomo Anedda Cristina Soddu Francesco Casti Miriam Biancu Silvia Puddu Selina Russo Andrea De Palma Francesco Pignatelli Elisa Loguercio Livia Palmieri Giulia Salvi Priscilla Francesca Procopio Eleonora Morelli Dorin Serbusca Alessio Biagio Filippo Giordano Giulia Fiorenza Sophie Leboulleux Nathalie Massé |
| author_facet | Gian Luigi Canu Fabio Medas Federico Cappellacci Leonardo Rossi Benard Gjeloshi Luca Sessa Luca Sessa Francesco Pennestrì Francesco Pennestrì Reza Djafarrian Maria Mavromati George Kotsovolis George Kotsovolis Ioannis Pliakos Ioannis Pliakos Giacomo Di Filippo Giovanni Lazzari Carla Vaccaro Martina Izzo Francesco Boi Paolo Brazzarola Francesco Feroci Francesco Feroci Marco Stefano Demarchi Theodossios Papavramidis Theodossios Papavramidis Gabriele Materazzi Marco Raffaelli Marco Raffaelli Pietro Giorgio Calò REDHOT Study Collaborative Group Giacomo Anedda Cristina Soddu Francesco Casti Miriam Biancu Silvia Puddu Selina Russo Andrea De Palma Francesco Pignatelli Elisa Loguercio Livia Palmieri Giulia Salvi Priscilla Francesca Procopio Eleonora Morelli Dorin Serbusca Alessio Biagio Filippo Giordano Giulia Fiorenza Sophie Leboulleux Nathalie Massé |
| author_sort | Gian Luigi Canu |
| collection | DOAJ |
| description | BackgroundPostoperative cervical haematoma represents an infrequent but potentially life-threatening complication of thyroidectomy. Since this complication is uncommon, the assessment of risk factors associated with its development is challenging. The main aim of this study was to identify the risk factors for its occurrence.MethodsPatients undergoing thyroidectomy in seven high-volume thyroid surgery centers in Europe, between January 2020 and December 2022, were retrospectively analysed. Based on the onset of cervical haematoma, two groups were identified: Cervical Haematoma (CH) Group and No Cervical Haematoma (NoCH) Group. Univariate analysis was performed to compare these two groups. Moreover, employing multivariate analysis, all potential independent risk factors for the development of this complication were assessed.ResultsEight thousand eight hundred and thirty-nine patients were enrolled: 8,561 were included in NoCH Group and 278 in CH Group. Surgical revision of haemostasis was performed in 70 (25.18%) patients. The overall incidence of postoperative cervical haematoma was 3.15% (0.79% for cervical haematomas requiring surgical revision of haemostasis, and 2.35% for those managed conservatively). The timing of onset of cervical haematomas requiring surgical revision of haemostasis was within six hours after the end of the operation in 52 (74.28%) patients. Readmission was necessary in 3 (1.08%) cases. At multivariate analysis, male sex (P < 0.001), older age (P < 0.001), higher BMI (P = 0.021), unilateral lateral neck dissection (P < 0.001), drain placement (P = 0.007), and shorter operative times (P < 0.001) were found to be independent risk factors for cervical haematoma.ConclusionsBased on our findings, we believe that patients with the identified risk factors should be closely monitored in the postoperative period, particularly during the first six hours after the operation, and excluded from outpatient surgery. |
| first_indexed | 2024-03-11T20:25:12Z |
| format | Article |
| id | doaj.art-5887606101f5422992efb8f8d4bc0109 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-11T20:25:12Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-5887606101f5422992efb8f8d4bc01092023-10-02T15:53:59ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-10-011010.3389/fsurg.2023.12786961278696Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)Gian Luigi Canu0Fabio Medas1Federico Cappellacci2Leonardo Rossi3Benard Gjeloshi4Luca Sessa5Luca Sessa6Francesco Pennestrì7Francesco Pennestrì8Reza Djafarrian9Maria Mavromati10George Kotsovolis11George Kotsovolis12Ioannis Pliakos13Ioannis Pliakos14Giacomo Di Filippo15Giovanni Lazzari16Carla Vaccaro17Martina Izzo18Francesco Boi19Paolo Brazzarola20Francesco Feroci21Francesco Feroci22Marco Stefano Demarchi23Theodossios Papavramidis24Theodossios Papavramidis25Gabriele Materazzi26Marco Raffaelli27Marco Raffaelli28Pietro Giorgio Calò29REDHOT Study Collaborative GroupGiacomo AneddaCristina SodduFrancesco CastiMiriam BiancuSilvia PudduSelina RussoAndrea De PalmaFrancesco PignatelliElisa LoguercioLivia PalmieriGiulia SalviPriscilla Francesca ProcopioEleonora MorelliDorin SerbuscaAlessio Biagio Filippo GiordanoGiulia FiorenzaSophie LeboulleuxNathalie MasséDepartment of Surgical Sciences, University of Cagliari, Monserrato, ItalyDepartment of Surgical Sciences, University of Cagliari, Monserrato, ItalyDepartment of Surgical Sciences, University of Cagliari, Monserrato, ItalyEndocrine Surgery Unit, University Hospital of Pisa, Pisa, ItalyEndocrine Surgery Unit, University Hospital of Pisa, Pisa, ItalyUOC di Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyCentro di Ricerca in Chirurgia Delle Ghiandole Endocrine e Dell’Obesità, Università Cattolica del Sacro Cuore, Rome, ItalyUOC di Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyCentro di Ricerca in Chirurgia Delle Ghiandole Endocrine e Dell’Obesità, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, Geneva, SwitzerlandService of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, WHO Collaborating Center, Geneva University Hospital, Geneva University, Geneva, SwitzerlandFirst Propedeutic Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, GreeceUnit of Minimally Invasive Surgery, Euromedica Kyanous Stavros, Thessaloniki, GreeceFirst Propedeutic Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, GreeceUnit of Minimally Invasive Surgery, Euromedica Kyanous Stavros, Thessaloniki, GreeceEndocrine Surgery Unit, Department of Surgery and Oncology, University and Hospital Trust of Verona, Verona, ItalyEndocrine Surgery Unit, Department of Surgery and Oncology, University and Hospital Trust of Verona, Verona, Italy0SOC Chirurgia Generale, Ospedale SS Cosma e Damiano, Pescia, Italy0SOC Chirurgia Generale, Ospedale SS Cosma e Damiano, Pescia, Italy1Department of Medical Sciences, University of Cagliari, Monserrato, ItalyEndocrine Surgery Unit, Department of Surgery and Oncology, University and Hospital Trust of Verona, Verona, Italy0SOC Chirurgia Generale, Ospedale SS Cosma e Damiano, Pescia, Italy2Department of General and Oncologic Surgery, Santo Stefano Hospital, Prato, ItalyDepartment of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, Geneva, SwitzerlandFirst Propedeutic Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, GreeceUnit of Minimally Invasive Surgery, Euromedica Kyanous Stavros, Thessaloniki, GreeceEndocrine Surgery Unit, University Hospital of Pisa, Pisa, ItalyUOC di Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyCentro di Ricerca in Chirurgia Delle Ghiandole Endocrine e Dell’Obesità, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Surgical Sciences, University of Cagliari, Monserrato, ItalyBackgroundPostoperative cervical haematoma represents an infrequent but potentially life-threatening complication of thyroidectomy. Since this complication is uncommon, the assessment of risk factors associated with its development is challenging. The main aim of this study was to identify the risk factors for its occurrence.MethodsPatients undergoing thyroidectomy in seven high-volume thyroid surgery centers in Europe, between January 2020 and December 2022, were retrospectively analysed. Based on the onset of cervical haematoma, two groups were identified: Cervical Haematoma (CH) Group and No Cervical Haematoma (NoCH) Group. Univariate analysis was performed to compare these two groups. Moreover, employing multivariate analysis, all potential independent risk factors for the development of this complication were assessed.ResultsEight thousand eight hundred and thirty-nine patients were enrolled: 8,561 were included in NoCH Group and 278 in CH Group. Surgical revision of haemostasis was performed in 70 (25.18%) patients. The overall incidence of postoperative cervical haematoma was 3.15% (0.79% for cervical haematomas requiring surgical revision of haemostasis, and 2.35% for those managed conservatively). The timing of onset of cervical haematomas requiring surgical revision of haemostasis was within six hours after the end of the operation in 52 (74.28%) patients. Readmission was necessary in 3 (1.08%) cases. At multivariate analysis, male sex (P < 0.001), older age (P < 0.001), higher BMI (P = 0.021), unilateral lateral neck dissection (P < 0.001), drain placement (P = 0.007), and shorter operative times (P < 0.001) were found to be independent risk factors for cervical haematoma.ConclusionsBased on our findings, we believe that patients with the identified risk factors should be closely monitored in the postoperative period, particularly during the first six hours after the operation, and excluded from outpatient surgery.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1278696/fullthyroidectomythyroid surgerycervical haematomableedingrisk factorscomplications |
| spellingShingle | Gian Luigi Canu Fabio Medas Federico Cappellacci Leonardo Rossi Benard Gjeloshi Luca Sessa Luca Sessa Francesco Pennestrì Francesco Pennestrì Reza Djafarrian Maria Mavromati George Kotsovolis George Kotsovolis Ioannis Pliakos Ioannis Pliakos Giacomo Di Filippo Giovanni Lazzari Carla Vaccaro Martina Izzo Francesco Boi Paolo Brazzarola Francesco Feroci Francesco Feroci Marco Stefano Demarchi Theodossios Papavramidis Theodossios Papavramidis Gabriele Materazzi Marco Raffaelli Marco Raffaelli Pietro Giorgio Calò REDHOT Study Collaborative Group Giacomo Anedda Cristina Soddu Francesco Casti Miriam Biancu Silvia Puddu Selina Russo Andrea De Palma Francesco Pignatelli Elisa Loguercio Livia Palmieri Giulia Salvi Priscilla Francesca Procopio Eleonora Morelli Dorin Serbusca Alessio Biagio Filippo Giordano Giulia Fiorenza Sophie Leboulleux Nathalie Massé Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study) Frontiers in Surgery thyroidectomy thyroid surgery cervical haematoma bleeding risk factors complications |
| title | Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study) |
| title_full | Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study) |
| title_fullStr | Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study) |
| title_full_unstemmed | Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study) |
| title_short | Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study) |
| title_sort | risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy a retrospective multicenter international analysis redhot study |
| topic | thyroidectomy thyroid surgery cervical haematoma bleeding risk factors complications |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1278696/full |
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