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Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis

BACKGROUND: To address the postoperative outcomes between outpatient and inpatient neck surgery involving thyroidectomy procedures. METHODS: A cohort analysis of surgical patients undergoing primary, elective, total thyroidectomy from multiple United States medical institutions who were registered w...

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Autores principales: Traill, Lauren, Kendall, Mark C., Caramez, Maria Paula, Apruzzese, Patricia, De Oliveira, Gildasio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408051/
https://www.ncbi.nlm.nih.gov/pubmed/37553707
http://dx.doi.org/10.1186/s13741-023-00335-x
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author Traill, Lauren
Kendall, Mark C.
Caramez, Maria Paula
Apruzzese, Patricia
De Oliveira, Gildasio
author_facet Traill, Lauren
Kendall, Mark C.
Caramez, Maria Paula
Apruzzese, Patricia
De Oliveira, Gildasio
author_sort Traill, Lauren
collection PubMed
description BACKGROUND: To address the postoperative outcomes between outpatient and inpatient neck surgery involving thyroidectomy procedures. METHODS: A cohort analysis of surgical patients undergoing primary, elective, total thyroidectomy from multiple United States medical institutions who were registered with the American College of Surgeons National Surgical Quality Improvement Program from 2015 to 2018. The primary outcome was a composite score that included any 30-day postoperative adverse event. RESULTS: A total of 55,381 patients who underwent a total thyroidectomy were identified comprising of 14,055 inpatient and 41,326 outpatient procedures. A cohort of 13,496 patients who underwent outpatient surgery were propensity matched for covariates with corresponding number of patients who underwent inpatient thyroidectomies. In the propensity matched cohort, the occurrence of any 30-day after surgery complications were greater in the inpatient group, 424 out of 13,496 (3.1%) compared to the outpatient group, 150 out of 13,496 (1.1%), P < 0.001. Moreover, death rates were greater in the inpatient group, 22 out 13,496 (0.16%) compared to the outpatient group, 2 out of 13,496 (0.01%), P < 0.001. Similarly, hospital readmissions occurred with greater frequency in the inpatient group, 438 out of 13,496 (3.2%) compared to the outpatient group, 310 out of 13,496 (2.3%), P < 0.001. CONCLUSION: Thyroidectomy procedures performed in the outpatient setting had less rates of adverse events, including serious postoperative complications (e.g., surgical site infection, pneumonia, progressive renal insufficiency). In addition, patients who had thyroidectomy in the outpatient setting had less 30-day readmissions and mortality. Surgeons should recognize the benefits of outpatient thyroidectomy when selecting disposition of patients undergoing neck surgery.
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spelling pubmed-104080512023-08-09 Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis Traill, Lauren Kendall, Mark C. Caramez, Maria Paula Apruzzese, Patricia De Oliveira, Gildasio Perioper Med (Lond) Research BACKGROUND: To address the postoperative outcomes between outpatient and inpatient neck surgery involving thyroidectomy procedures. METHODS: A cohort analysis of surgical patients undergoing primary, elective, total thyroidectomy from multiple United States medical institutions who were registered with the American College of Surgeons National Surgical Quality Improvement Program from 2015 to 2018. The primary outcome was a composite score that included any 30-day postoperative adverse event. RESULTS: A total of 55,381 patients who underwent a total thyroidectomy were identified comprising of 14,055 inpatient and 41,326 outpatient procedures. A cohort of 13,496 patients who underwent outpatient surgery were propensity matched for covariates with corresponding number of patients who underwent inpatient thyroidectomies. In the propensity matched cohort, the occurrence of any 30-day after surgery complications were greater in the inpatient group, 424 out of 13,496 (3.1%) compared to the outpatient group, 150 out of 13,496 (1.1%), P < 0.001. Moreover, death rates were greater in the inpatient group, 22 out 13,496 (0.16%) compared to the outpatient group, 2 out of 13,496 (0.01%), P < 0.001. Similarly, hospital readmissions occurred with greater frequency in the inpatient group, 438 out of 13,496 (3.2%) compared to the outpatient group, 310 out of 13,496 (2.3%), P < 0.001. CONCLUSION: Thyroidectomy procedures performed in the outpatient setting had less rates of adverse events, including serious postoperative complications (e.g., surgical site infection, pneumonia, progressive renal insufficiency). In addition, patients who had thyroidectomy in the outpatient setting had less 30-day readmissions and mortality. Surgeons should recognize the benefits of outpatient thyroidectomy when selecting disposition of patients undergoing neck surgery. BioMed Central 2023-08-08 /pmc/articles/PMC10408051/ /pubmed/37553707 http://dx.doi.org/10.1186/s13741-023-00335-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Traill, Lauren
Kendall, Mark C.
Caramez, Maria Paula
Apruzzese, Patricia
De Oliveira, Gildasio
Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis
title Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis
title_full Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis
title_fullStr Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis
title_full_unstemmed Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis
title_short Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis
title_sort outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408051/
https://www.ncbi.nlm.nih.gov/pubmed/37553707
http://dx.doi.org/10.1186/s13741-023-00335-x
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