Evacuation of postoperative hematomas after thyroid and parathyroid surgery: An analysis of the CESQIP Database

Talutis, Stephanie D.; Drake, Frederick Thurston; Sachs, Teviah E.; Rao, Sowmya R.; McAneny, David

doi:10.1016/j.surg.2018.04.087

Cited by 17 publications

(16 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Male sex is a well-known risk factor for PH, identified in many previous studies. 1,2,9,10 Time intervals from end of surgery to the onset of PH were generally within 12 h, which was also similar to the findings of previous studies. Burkey et al reported that 43% of instances of PH occurred within 6 h, and 81% occurred within 24 h. 3 Lang et al noted that 72.7% of instances of PH occurred within 6 h, and 100% occurred within 24 h. 4 As most instances of PH occur within 24 hours, vigilant monitoring for PH during the early postoperative period is essential for patients at high risk.…”

Section: Discussionsupporting

confidence: 89%

“…However, we found no statistically significant correlation. 1,3,15 Notably, the present study is the first to identify a statistically significant relationship between PH and postoperative pain. 5,14 However, their study was limited in that they did not control variables that might increase postoperative systolic BP, such as postoperative pain and medication.…”

Section: Discussionmentioning

confidence: 64%

“…1 The reported incidence of post-thyroidectomy hematoma (PH) ranges from 0.43% to 4.39%. Complications after thyroidectomy are wellknown, but are rare; these include recurrent laryngeal nerve paralysis, hypoparathyroidism, and post-thyroidectomy hematoma.…”

Section: Introductionmentioning

confidence: 99%

“…Complications after thyroidectomy are wellknown, but are rare; these include recurrent laryngeal nerve paralysis, hypoparathyroidism, and post-thyroidectomy hematoma. [1][2][3][4][5][6][7][8][9][10][11] In this study, we sought to identify perioperative risk factors for PH, with emphasis on perioperative hemodynamics and medications, along with well-known risk factors, such as sex, age, and type of operation. 2 Notably, PH is an uncommon, but life-threatening complication, which can induce upper airway obstruction, acute respiratory failure, and death.…”

Section: Introductionmentioning

confidence: 99%

“…Complications after thyroidectomy are wellknown, but are rare; these include recurrent laryngeal nerve paralysis, hypoparathyroidism, and post-thyroidectomy hematoma. 1 The reported incidence of post-thyroidectomy hematoma (PH) ranges from 0.43% to 4.39%. 2 Notably, PH is an uncommon, but life-threatening complication, which can induce upper airway obstruction, acute respiratory failure, and death.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Perioperative risk factors for post‐thyroidectomy hematoma: Significance of pain and ketorolac usage

et al. 2019

View full text Add to dashboard Cite

Background Post‐thyroidectomy hematoma (PH) is uncommon but may be a life‐threatening complication. We explored perioperative risk factors for PH, with emphasis on perioperative hemodynamics, pain, and medications. Methods A retrospective case‐control study was performed with matching for age, sex, and type of operation. Univariate and multivariate analyses were performed to identify independent risk factors. Results In 1780 thyroid surgeries, 22 cases of PH were detected (1.24%). Antithrombotic agent usage, numeric rating scale (NRS) of postoperative pain, and two or more doses of ketorolac postoperatively significantly differed between the two groups. Multiple regression analysis revealed all three variables were significant risk factors for PH (odds ratio = 55.23, 10.48, and 22.58, respectively). Perioperative hemodynamics did not affect PH. Conclusions Antithrombotic agent usage, postoperative pain, and two or more doses of ketorolac postoperatively were identified as independent risk factors for PH. Proper pain control and judicious usage of ketorolac are recommended.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Complications after thyroidectomy are wellknown, but are rare; these include recurrent laryngeal nerve paralysis, hypoparathyroidism, and post-thyroidectomy hematoma. 1 The reported incidence of post-thyroidectomy hematoma (PH) ranges from 0.43% to 4.39%. 2 Notably, PH is an uncommon, but life-threatening complication, which can induce upper airway obstruction, acute respiratory failure, and death.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Perioperative risk factors for post‐thyroidectomy hematoma: Significance of pain and ketorolac usage

et al. 2019

View full text Add to dashboard Cite

show abstract

Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management

2019

View full text Add to dashboard Cite

Introduction Bleeding after thyroid and/or parathyroid surgery is a life-threatening emergency. The aim of this study was to determine the rates of reoperation following bleeding, identify risk factors, assess management strategies and outcomes, and develop protocols to reduce risk and improve management of bleeding. Methods A retrospective cohort study of all consecutive patients who underwent thyroid and/or parathyroid surgery over a 7-year period was conducted. A nested case-control design was used to evaluate specific factors and their association with reoperation for bleeding. Results Of 1913 patients, 25 (1.3%) underwent reoperation for bleeding. Of the 25 patients who bled, 6 (24%) required reoperation before leaving theatre; 17 (68%) had bleeding within 6 h, 1 (4%) between 6 and 24 h, and 1 (4%) after 24 h. Reoperation for bleeding was not associated with age, gender, or surgeon. Patients who had total thyroidectomy were more likely to have reoperation for bleeding compared to hemithyroidectomy (p = 0.045) or parathyroidectomy (p = 0.001). The following factors were not associated with bleeding: neck dissection, redo surgery, drain use, blood-thinning medication or clotting disorders, and BMI. Patients who had reoperation for bleeding had longer hospital stay (p = 0.001), but similar rates of RLN palsy, wound infection, and hypoparathyroidism. Conclusion A higher risk profile for significant post-operative bleeding cannot be determined in patients undergoing thyroid surgery. Based on this experience, we developed protocols to reduce the risk of bleeding (the ITSRED Fred protocol) and for the early detection and management of bleed (the SCOOP protocol) following thyroid and/or parathyroid surgery.

show abstract

Diabetes mellitus and hyperglycemia are associated with inferior oncologic outcomes in adrenocortical carcinoma

Wrenn

Pandian

Gartland

et al. 2021

Langenbecks Arch Surg

View full text Add to dashboard Cite

Evacuation of postoperative hematomas after thyroid and parathyroid surgery: An analysis of the CESQIP Database

Cited by 17 publications

References 24 publications

Perioperative risk factors for post‐thyroidectomy hematoma: Significance of pain and ketorolac usage

Perioperative risk factors for post‐thyroidectomy hematoma: Significance of pain and ketorolac usage

Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management

Diabetes mellitus and hyperglycemia are associated with inferior oncologic outcomes in adrenocortical carcinoma

Contact Info

Product

Resources

About