Incidence and risk factor for short term postoperative cough after thyroidectomy

Abstract

Background : The prevalence of and potential risk factors for postoperative cough after thyroidectomy remain unknown. The current study aimed to analyze postoperative cough in patients undergoing thyroidectomy using a prospective analysis. Methods : Adult patients undergoing primary thyroidectomy were prospectively enrolled. Data regarding age, sex, BMI, pathology and surgical procedure were collected and analyzed. All patients were asked to complete the Leicester Cough Questionnaire (LCQ) preoperatively and at 2 weeks and 4 weeks postoperatively. Results : There were 1264 patients enrolled in total. Eleven patients with vocal cord paralysis were excluded. In patients with benign disease, postoperative cough occurred in 61 patients, with an prevalence rate of 17. 0% compared to an prevalence rate of 33.1% in patients with malignant disease; the difference was significant. For benign patients, the factors of smoking and operation time were independently related to the occurrence of postoperative cough. For malignant patients, the factors of smoking, operation time, operation extent, and the number of positive nodes at level 6 were independently related to the occurrence of postoperative cough. There was no significant difference regarding the LCQ score in patients with benign or malignant disease at the preoperative and the postoperative 4-week time periods. Patients with malignant disease had a significantly lower LCQ score than patients with benign disease at the postoperative 2-week time point (p=0.004). Conclusions : Patients undergoing thyroid cancer surgery had a higher prevalence of postoperative cough and were also associated with a decreased cough-related quality of life. The factors of smoking and operation time were the most important predictors for postoperative cough after thyroidectomy.