Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis
Abstract Background To address the postoperative outcomes between outpatient and inpatient neck surgery involving thyroidectomy procedures. Methods A cohort analysis of surgical patients undergoing primary, elective, total thyroidectomy from multiple United States medical institutions who were regis...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | Perioperative Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13741-023-00335-x |
| _version_ | 1797557631981715456 |
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| author | Lauren Traill Mark C. Kendall Maria Paula Caramez Patricia Apruzzese Gildasio De Oliveira |
| author_facet | Lauren Traill Mark C. Kendall Maria Paula Caramez Patricia Apruzzese Gildasio De Oliveira |
| author_sort | Lauren Traill |
| collection | DOAJ |
| description | Abstract Background To address the postoperative outcomes between outpatient and inpatient neck surgery involving thyroidectomy procedures. Methods A cohort analysis of surgical patients undergoing primary, elective, total thyroidectomy from multiple United States medical institutions who were registered with the American College of Surgeons National Surgical Quality Improvement Program from 2015 to 2018. The primary outcome was a composite score that included any 30-day postoperative adverse event. Results A total of 55,381 patients who underwent a total thyroidectomy were identified comprising of 14,055 inpatient and 41,326 outpatient procedures. A cohort of 13,496 patients who underwent outpatient surgery were propensity matched for covariates with corresponding number of patients who underwent inpatient thyroidectomies. In the propensity matched cohort, the occurrence of any 30-day after surgery complications were greater in the inpatient group, 424 out of 13,496 (3.1%) compared to the outpatient group, 150 out of 13,496 (1.1%), P < 0.001. Moreover, death rates were greater in the inpatient group, 22 out 13,496 (0.16%) compared to the outpatient group, 2 out of 13,496 (0.01%), P < 0.001. Similarly, hospital readmissions occurred with greater frequency in the inpatient group, 438 out of 13,496 (3.2%) compared to the outpatient group, 310 out of 13,496 (2.3%), P < 0.001. Conclusion Thyroidectomy procedures performed in the outpatient setting had less rates of adverse events, including serious postoperative complications (e.g., surgical site infection, pneumonia, progressive renal insufficiency). In addition, patients who had thyroidectomy in the outpatient setting had less 30-day readmissions and mortality. Surgeons should recognize the benefits of outpatient thyroidectomy when selecting disposition of patients undergoing neck surgery. |
| first_indexed | 2024-03-10T17:19:21Z |
| format | Article |
| id | doaj.art-7d53ddb59327476988d615d0ab27aec1 |
| institution | Directory Open Access Journal |
| issn | 2047-0525 |
| language | English |
| last_indexed | 2024-03-10T17:19:21Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj.art-7d53ddb59327476988d615d0ab27aec12023-11-20T10:23:25ZengBMCPerioperative Medicine2047-05252023-08-011211910.1186/s13741-023-00335-xOutpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysisLauren Traill0Mark C. Kendall1Maria Paula Caramez2Patricia Apruzzese3Gildasio De Oliveira4Department of Anesthesiology, The Warren Alpert Medical School of Brown UniversityDepartment of Anesthesiology, The Warren Alpert Medical School of Brown UniversityDepartment of Anesthesiology, The Warren Alpert Medical School of Brown UniversityDepartment of Anesthesiology, Rhode Island HospitalDepartment of Anesthesiology, The Warren Alpert Medical School of Brown UniversityAbstract Background To address the postoperative outcomes between outpatient and inpatient neck surgery involving thyroidectomy procedures. Methods A cohort analysis of surgical patients undergoing primary, elective, total thyroidectomy from multiple United States medical institutions who were registered with the American College of Surgeons National Surgical Quality Improvement Program from 2015 to 2018. The primary outcome was a composite score that included any 30-day postoperative adverse event. Results A total of 55,381 patients who underwent a total thyroidectomy were identified comprising of 14,055 inpatient and 41,326 outpatient procedures. A cohort of 13,496 patients who underwent outpatient surgery were propensity matched for covariates with corresponding number of patients who underwent inpatient thyroidectomies. In the propensity matched cohort, the occurrence of any 30-day after surgery complications were greater in the inpatient group, 424 out of 13,496 (3.1%) compared to the outpatient group, 150 out of 13,496 (1.1%), P < 0.001. Moreover, death rates were greater in the inpatient group, 22 out 13,496 (0.16%) compared to the outpatient group, 2 out of 13,496 (0.01%), P < 0.001. Similarly, hospital readmissions occurred with greater frequency in the inpatient group, 438 out of 13,496 (3.2%) compared to the outpatient group, 310 out of 13,496 (2.3%), P < 0.001. Conclusion Thyroidectomy procedures performed in the outpatient setting had less rates of adverse events, including serious postoperative complications (e.g., surgical site infection, pneumonia, progressive renal insufficiency). In addition, patients who had thyroidectomy in the outpatient setting had less 30-day readmissions and mortality. Surgeons should recognize the benefits of outpatient thyroidectomy when selecting disposition of patients undergoing neck surgery.https://doi.org/10.1186/s13741-023-00335-xThyroidectomyOutpatient surgeryACS NSQIPNeck surgeryPostoperative complications |
| spellingShingle | Lauren Traill Mark C. Kendall Maria Paula Caramez Patricia Apruzzese Gildasio De Oliveira Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis Perioperative Medicine Thyroidectomy Outpatient surgery ACS NSQIP Neck surgery Postoperative complications |
| title | Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis |
| title_full | Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis |
| title_fullStr | Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis |
| title_full_unstemmed | Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis |
| title_short | Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis |
| title_sort | outpatient compared to inpatient thyroidectomy on 30 day postoperative outcomes a national propensity matched analysis |
| topic | Thyroidectomy Outpatient surgery ACS NSQIP Neck surgery Postoperative complications |
| url | https://doi.org/10.1186/s13741-023-00335-x |
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