Q Lina Hu1, Masha J Livhits2, Clifford Y Ko3, Michael W Yeh2. 1. Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL. Electronic address: lhu@facs.org. 2. Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA; Section of Endocrine Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA. 3. Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL.
Abstract
BACKGROUND: Overnight hospitalization after thyroid surgery has been a widely adopted practice because of the concern for complications such as hypocalcemia and hematoma. Same-day discharge, however, has become popular in recent years. METHODS: The American College of Surgeons National Surgical Quality Improvement Program Targeted Thyroidectomy database (2016-2017) was used to identify patients who underwent thyroid resections. A 1:1 propensity score matching was used to match patients who were discharged on postoperative day 0 and those discharged on postoperative days 1 or 2. Multivariable logistic regression models were constructed to assess the association between discharge timing and postoperative outcomes. RESULTS: Of the 10,502 patients, 2,776 (26.4%) were discharged on postoperative day 0, and 7,726 (73.6%) were discharged on postoperative days 1 or 2. After propensity score matching, 1,977 matched pairs were created. In this matched cohort, the rates of readmission were similar when comparing patients discharged on postoperative day 0 with those discharged on postoperative days 1 or 2 (odds ratio 1.26, 95% confidence interval 0.78-2.05). Likewise, no differences were observed in the rates of surgical site infection, clinically severe hypocalcemia, neck hematoma, or recurrent laryngeal nerve injury. CONCLUSION: In a national cohort of patients undergoing thyroid surgery, same-day discharge was not associated with greater rates of readmission or complications when compared with discharge 1 or 2 days after thyroid surgery.
BACKGROUND: Overnight hospitalization after thyroid surgery has been a widely adopted practice because of the concern for complications such as hypocalcemia and hematoma. Same-day discharge, however, has become popular in recent years. METHODS: The American College of Surgeons National Surgical Quality Improvement Program Targeted Thyroidectomy database (2016-2017) was used to identify patients who underwent thyroid resections. A 1:1 propensity score matching was used to match patients who were discharged on postoperative day 0 and those discharged on postoperative days 1 or 2. Multivariable logistic regression models were constructed to assess the association between discharge timing and postoperative outcomes. RESULTS: Of the 10,502 patients, 2,776 (26.4%) were discharged on postoperative day 0, and 7,726 (73.6%) were discharged on postoperative days 1 or 2. After propensity score matching, 1,977 matched pairs were created. In this matched cohort, the rates of readmission were similar when comparing patients discharged on postoperative day 0 with those discharged on postoperative days 1 or 2 (odds ratio 1.26, 95% confidence interval 0.78-2.05). Likewise, no differences were observed in the rates of surgical site infection, clinically severe hypocalcemia, neck hematoma, or recurrent laryngeal nerve injury. CONCLUSION: In a national cohort of patients undergoing thyroid surgery, same-day discharge was not associated with greater rates of readmission or complications when compared with discharge 1 or 2 days after thyroid surgery.
Authors: Justine Philteos; Elif Baran; Christopher W Noel; Jesse D Pasternak; Kevin M Higgins; Jeremy L Freeman; Albino Chiodo; Antoine Eskander Journal: Front Endocrinol (Lausanne) Date: 2021-07-28 Impact factor: 5.555