Randall P Morton1,2, Alain C Vandal3,4. 1. Department of Otolaryngology-Head and Neck Surgery, Counties-Manukau Health, Manukau City, Auckland, New Zealand. 2. Department of Surgery, University of Auckland, Auckland, New Zealand. 3. Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand. 4. Ko Awatea, Counties Manukau Health, Auckland, New Zealand.
Abstract
OBJECTIVES: To examine potential factors that may predict development of postoperative haematoma following thyroid surgery, with particular attention to postoperative systolic blood pressure. DESIGN: Retrospective, observational case-control study of patients undergoing thyroid surgery. SETTING: Secondary General Hospital. PARTICIPANTS: Patients attending Counties Manukau District Health Board (CMDHB) between 2002 and 2012. MAIN OUTCOME MEASURES: Post-operative Haematoma formation that required re-exploration of the wound. RESULTS: The overall rate of postoperative haematoma was 2.57% (16/621). Three patients bled immediately (i.e. after wound closure but while still on the operating table); 10 patients (1.6%) bled in the early postoperative period; and three others bled 24 h or more after surgery. The principal independent risk factor for postoperative haemorrhage that remained after multivariable regression was postoperative systolic blood pressure level. There was a 39% increase in risk of bleeding for every 10 points rise of highest blood pressure recordings in our patient population (OR 1.39; 95% CI = 1.09-1.8). CONCLUSIONS: This study identifies postoperative hypertension as significantly related to development of early postoperative haematoma. Cause for late post-thyroidectomy bleeding remains speculative.
OBJECTIVES: To examine potential factors that may predict development of postoperative haematoma following thyroid surgery, with particular attention to postoperative systolic blood pressure. DESIGN: Retrospective, observational case-control study of patients undergoing thyroid surgery. SETTING: Secondary General Hospital. PARTICIPANTS: Patients attending Counties Manukau District Health Board (CMDHB) between 2002 and 2012. MAIN OUTCOME MEASURES: Post-operative Haematoma formation that required re-exploration of the wound. RESULTS: The overall rate of postoperative haematoma was 2.57% (16/621). Three patients bled immediately (i.e. after wound closure but while still on the operating table); 10 patients (1.6%) bled in the early postoperative period; and three others bled 24 h or more after surgery. The principal independent risk factor for postoperative haemorrhage that remained after multivariable regression was postoperative systolic blood pressure level. There was a 39% increase in risk of bleeding for every 10 points rise of highest blood pressure recordings in our patient population (OR 1.39; 95% CI = 1.09-1.8). CONCLUSIONS: This study identifies postoperative hypertension as significantly related to development of early postoperative haematoma. Cause for late post-thyroidectomy bleeding remains speculative.
Authors: Lee D Ying; Andrew J Duffy; Kurt E Roberts; Saber Ghiassi; Matthew O Hubbard; Geoffrey S Nadzam Journal: Obes Surg Date: 2019-06 Impact factor: 4.129