Safety and cost-effectiveness of outpatient thyroidectomy

Abstract

To investigate the safety and cost-effectiveness of outpatient thyroidectomy and provide a systematic postoperative protocol for safe discharge. Methods: In this retrospective review, the medical records of all patients who underwent total, hemi, or completion thyroidectomy from July 2017 to April 2019 at 2 tertiary care hospitals were reviewed. Multivariable analysis was performed on the potential predictors of postoperative complications. Healthcare costs were calculated by the type of admission based on the average costs at the 2 centers. Results: One hundred twenty-two patients were enrolled in this study. The majority of cases were in the outpatient group (n=76, 62.3%). Total Original Article thyroidectomy was the most prevalent type of surgery (n=90, 73.7%). There were a total of 20 complications in 18 patients (inpatient=9 versus [vs.] outpatient=9). No cases of cervical hematoma or bilateral vocal cord paralysis were encountered. No significant difference was found between the type of admission (outpatient vs. inpatient) and postsurgical complications (p=0.24). The multivariable regression model retained significance for male gender and American Society of Anesthesiologists Classification III as potential predictors of postoperative complications. Healthcare costs would be reduced by at least 15.5% with the implementation of outpatient surgery. Conclusion: Outpatient thyroidectomy is as safe as inpatient thyroidectomy given the proper selection of cases. We project cost containment of over $711 thousand per 1,000 cases for outpatient thyroid surgeries.

Post-thyroidectomy complications in southwestern Saudi Arabia: a retrospective study of a 6-year period

“…On the other hand, Al-Qahtani et al in Tabuk reported an overall prevalence of 72.3%, 12 while Al-Hakami et al from Jeddah reported a complication rate of 43.45%, 13 and Qobty et al from Aseer region reported a rate as high as 91%. 14 Relatively moderate rates were reported by Al-Eissa et al from Riyadh (14.8%), 15 Al-Amri from Dammam (17.4%) 16 and Al-Shareef et al from Makkah region (16%). 17 In most studies, hypocalcemia is the commonest complication encountered following thyroidectomy.…”

“…Table 5 shows the various complications recorded in different centers across Saudi Arabia. [11][12][13][14][15][16][17] Al-Harbi and Ahmed reported an overall prevalence of 9.6% among 310 patients who underwent thyroidectomy. 11 However, this was a retrospective study and only three major complication types were deliberately recorded.…”

Risk of hematoma after hemithyroidectomy in an outpatient setting: a systematic review and meta-analysis

“…The included studies [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] comprised of 46,866 patients divided into 37,814 inpatients and 9025 outpatients. Study characteristics and data from each of these studies are presented in Table 1.…”

Comment on: Safety and cost-effectiveness of outpatient thyroidectomy

“…The paper of AlEssa et al 1 is concerning a debated issue since several years: can same day thyroidectomy be performed safely? Although the number of reported patients is relatively low, the outcome between outpatients and inpatients was not different in the experience of the authors, being in line with previous studies, 2 provided a high-volume surgeon as in this report, is available.…”

“…We thank Dr. Sandro Contini for his interest and invaluable comment on our study, “Safety and cost-effectiveness of outpatient thyroidectomy A retrospective observational study.” 1 …”