Jean-Christophe Lifante1, Cécile Payet2, Fabrice Ménégaux3, Frédéric Sebag3, Jean-Louis Kraimps4, Jean-Louis Peix5, François Pattou6, Cyrille Colin7, Antoine Duclos7. 1. Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Chirurgie Générale et Endocrinienne, Pierre Bénite, Université Claude Bernard Lyon 1, Health Services and Performance Research Lab, Lyon, France; Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France. Electronic address: jean-christophe.lifante@chu-lyon.fr. 2. Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France. 3. Department of Endocrine Surgery, Jean Bernard Hospital, Poitiers, France. 4. Poitiers University, Jean Bernard Hospital, Poitiers, France. 5. Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Chirurgie Générale et Endocrinienne, Pierre Bénite, Université Claude Bernard Lyon 1, Health Services and Performance Research Lab, Lyon, France. 6. CHRU de Lille, Chirurgie Générale et Endocrinienne, Lille, France; Université Lille nord de France, INSERM, Lille, France. 7. Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France; Assistance Publique-Hôpitaux de Paris, Hôpital la Pitié-Salpêtrière, Service de Chirurgie Générale, Viscérale et Endocrinienne, Paris, Assistance Publique-Hôpitaux de Marseille, CHU la Conception, France.
Abstract
BACKGROUND: Permanent recurrent laryngeal nerve palsy and hypoparathyroidism are 2 major complications after thyroid operation. Assuming that the rate of immediate complications can predict the permanent complication rate, some authors consider these complications as a valid metric for assessing the performance of individual surgeons. This study aimed to determine the correlation between rates of immediate and permanent complications after thyroidectomy at the surgeon level. METHODS: We conducted a prospective, cross-sectional study in 5 academic hospitals between April 2008 and December 2009. The correlation between the rates of immediate and permanent complications for each of the 22 participating surgeons was calculated using the Pearson correlation test (r). RESULTS: The study period included 3,605 patients. There was a fairly good correlation between rates of immediate and permanent recurrent laryngeal nerve palsy (r = 0.70, P = .004), but no correlation was found for immediate and permanent hypoparathyroidism (r = 0.18, P = .427). CONCLUSION: The immediate hypoparathyroidism rate does not reflect the permanent hypoparathyroidism rate. Consequently, immediate hypoparathyroidism should not be used to assess the quality of thyroidectomy or to monitor the performance of surgeons.
BACKGROUND: Permanent recurrent laryngeal nerve palsy and hypoparathyroidism are 2 major complications after thyroid operation. Assuming that the rate of immediate complications can predict the permanent complication rate, some authors consider these complications as a valid metric for assessing the performance of individual surgeons. This study aimed to determine the correlation between rates of immediate and permanent complications after thyroidectomy at the surgeon level. METHODS: We conducted a prospective, cross-sectional study in 5 academic hospitals between April 2008 and December 2009. The correlation between the rates of immediate and permanent complications for each of the 22 participating surgeons was calculated using the Pearson correlation test (r). RESULTS: The study period included 3,605 patients. There was a fairly good correlation between rates of immediate and permanent recurrent laryngeal nerve palsy (r = 0.70, P = .004), but no correlation was found for immediate and permanent hypoparathyroidism (r = 0.18, P = .427). CONCLUSION: The immediate hypoparathyroidism rate does not reflect the permanent hypoparathyroidism rate. Consequently, immediate hypoparathyroidism should not be used to assess the quality of thyroidectomy or to monitor the performance of surgeons.
Authors: Jason B Liu; Julie A Sosa; Raymon H Grogan; Yaoming Liu; Mark E Cohen; Clifford Y Ko; Bruce L Hall Journal: JAMA Surg Date: 2018-01-17 Impact factor: 14.766