Regina Promberger1, Johannes Ott2, Claudia Bures3, Friedrich Kober3, Michael Freissmuth4, Rudolf Seemann5, Michael Hermann3. 1. Second Department of Surgery "Kaiserin Elisabeth", Krankenanstalt Rudolfstiftung, Vienna, Austria; Department of Surgery, Medical University of Vienna, Vienna, Austria. 2. Second Department of Surgery "Kaiserin Elisabeth", Krankenanstalt Rudolfstiftung, Vienna, Austria; Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria. Electronic address: johannes.ott@meduniwien.ac.at. 3. Second Department of Surgery "Kaiserin Elisabeth", Krankenanstalt Rudolfstiftung, Vienna, Austria. 4. Department of Craniomaxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria. 5. Second Department of Surgery "Kaiserin Elisabeth", Krankenanstalt Rudolfstiftung, Vienna, Austria; Institute of Pharmacology, Centre for Biomolecular Medicine and Pharmacology, Medical University of Vienna, Vienna, Austria.
Abstract
BACKGROUND: Thyroid surgery can cause postoperative hypocalcemia (POH) and permanent hypoparathyroidism (PEH). Surgeons implicitly assess the risk and adapt their surgical strategy accordingly. METHODS: The outcome of this intraoperative decision-making process (the surgeons' ability to predict the risk of POH and PEH on a numerical rating scale and their actual incidence) was studied prospectively in 2,558 consecutive thyroid operations. RESULTS: POH and PEH occurred in 723 and 64 patients, respectively. In multivariate analysis, the surgeons' risk assessment score was an independent predictive factor for both complications (P < .05). Surgeons' differed significantly (P = .015) in their rates of POH but not of PEH (P = .062). Six and 3 (of 9) surgeons correctly predicted an increased risk of PEH and POH (adjusted odds ratios 1.67 to 2.21 and 1.47 to 12.73), respectively. CONCLUSION: The risk for hypoparathyroidism can be estimated, but surgeons differ substantially in this ability and in the extent to which this implicit knowledge is translated into lower complication rates.
BACKGROUND: Thyroid surgery can cause postoperative hypocalcemia (POH) and permanent hypoparathyroidism (PEH). Surgeons implicitly assess the risk and adapt their surgical strategy accordingly. METHODS: The outcome of this intraoperative decision-making process (the surgeons' ability to predict the risk of POH and PEH on a numerical rating scale and their actual incidence) was studied prospectively in 2,558 consecutive thyroid operations. RESULTS: POH and PEH occurred in 723 and 64 patients, respectively. In multivariate analysis, the surgeons' risk assessment score was an independent predictive factor for both complications (P < .05). Surgeons' differed significantly (P = .015) in their rates of POH but not of PEH (P = .062). Six and 3 (of 9) surgeons correctly predicted an increased risk of PEH and POH (adjusted odds ratios 1.67 to 2.21 and 1.47 to 12.73), respectively. CONCLUSION: The risk for hypoparathyroidism can be estimated, but surgeons differ substantially in this ability and in the extent to which this implicit knowledge is translated into lower complication rates.
Authors: Alik Farber; Peter B Imrey; Thomas S Huber; James M Kaufman; Larry W Kraiss; Brett Larive; Liang Li; Harold I Feldman Journal: J Vasc Surg Date: 2016-01 Impact factor: 4.268
Authors: Elisabeth Gschwandtner; Rudolf Seemann; Claudia Bures; Lejla Preldzic; Eduard Szucsik; Michael Hermann Journal: Eur Surg Date: 2017-12-13 Impact factor: 0.953