Risk factors for post-thyroidectomy haematoma

Perera, Marlon; Anabell, L; Page, Daniel; Harding, Tanner; Gnaneswaran, Neiraja; Chan, Stephen

doi:10.1017/s0022215115003199

Cited by 23 publications

(30 citation statements)

References 31 publications

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“…4,7,10 However, many other studies reported that antithrombotic agent usage was an important risk factor for PH 2,6,9 ; in the present study, we identified antithrombotic agent usage as an independent risk factor for PH, with a corresponding 55-fold increase in risk. 4,7,10 However, many other studies reported that antithrombotic agent usage was an important risk factor for PH 2,6,9 ; in the present study, we identified antithrombotic agent usage as an independent risk factor for PH, with a corresponding 55-fold increase in risk.…”

Section: Discussionsupporting

confidence: 46%

“…Some studies could not identify a statistically significant correlation between antithrombotic agent usage and PH. 4,7,10 However, many other studies reported that antithrombotic agent usage was an important risk factor for PH 2,6,9 ; in the present study, we identified antithrombotic agent usage as an independent risk factor for PH, with a corresponding 55-fold increase in risk.…”

Section: Discussionsupporting

confidence: 46%

“…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%

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

et al. 2019

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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.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionsupporting

confidence: 46%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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“…Bleeding after thyroid or parathyroid surgery is a lifethreatening emergency as it has the potential to compromise the airway [1]. Reoperation for bleeding can be considered an objective way of quantifying rates of significant bleeding and has been reported to occur in around 0.07 to 4.2% of such neck operations [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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

2019

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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.

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“…1 Most common indications for thyroidectomy are toxic nodules, multinodular goitre, graves disease and malignancy. 2 Most common complications of total thyroidectomy are recurrent laryngeal nerve palsy and transient hypocalcaemia. Post-operative hypocalcaemia is the most frequent cause of emergency hospital admissions, it can be treated immediately by intravenous calcium infusion.…”

Section: Introductionmentioning

confidence: 99%

Frequency of post-operative complications of thyroidectomy.

Pathan

Mallah

Abbasi

2019

TPMJ

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Objectives: The objective of this study is to determine the frequency of post-operative complications of thyroidectomy. Study Design: Observational study. Setting: LUMHS Jamshoro at the Surgery Department. Period: January 2016 to December 2017. Material and Method: During these two years all the patients visiting surgery department with thyroid swelling were assessed. Assessment of thyroid swelling was done by detailed history and clinical examination. For further assessment of the swelling thyroid function tests (serum T3, T4, TSH level), ultrasound, isotope scanning and FNAC was performed. Assessed post-operative complications of thyroidectomy. Results: After assessment thyroidectomy was performed in 143 patients. Among them there were 37 males and 106 females. The ages of patients were in the range of 15-55 years and mean age was found to be 38 years. All of these patients have visited us due to complain of thyroid swelling. After complete assessment it was found that most commonly diagnosed thyroid swelling was multinodular goitre (51.04%). On ultrasound findings 60% of patients showed solid consistency whereas cystic and mixed were found in less patients. Post-operative complications were found in 61 patients (42.6%). Hypocalcaemia was the most frequent complication found in 14.68% of patients. Conclusion: Thyroidectomy is a commonly performed procedure in endocrine surgery with low morbidity and mortality. Despite improvements in surgical techniques and anaesthetic equipment, the rate of complications in thyroidectomy is constant. Post-operative measurement of calcium levels in susceptible patients can prevent tetany and emergency room admissions.

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Risk factors for post-thyroidectomy haematoma

Cited by 23 publications

References 31 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

Frequency of post-operative complications of thyroidectomy.

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