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Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)

BACKGROUND: Postoperative cervical haematoma represents an infrequent but potentially life-threatening complication of thyroidectomy. Since this complication is uncommon, the assessment of risk factors associated with its development is challenging. The main aim of this study was to identify the ris...

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Autores principales: Canu, Gian Luigi, Medas, Fabio, Cappellacci, Federico, Rossi, Leonardo, Gjeloshi, Benard, Sessa, Luca, Pennestrì, Francesco, Djafarrian, Reza, Mavromati, Maria, Kotsovolis, George, Pliakos, Ioannis, Di Filippo, Giacomo, Lazzari, Giovanni, Vaccaro, Carla, Izzo, Martina, Boi, Francesco, Brazzarola, Paolo, Feroci, Francesco, Demarchi, Marco Stefano, Papavramidis, Theodossios, Materazzi, Gabriele, Raffaelli, Marco, Calò, Pietro Giorgio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577166/
https://www.ncbi.nlm.nih.gov/pubmed/37850042
http://dx.doi.org/10.3389/fsurg.2023.1278696
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author Canu, Gian Luigi
Medas, Fabio
Cappellacci, Federico
Rossi, Leonardo
Gjeloshi, Benard
Sessa, Luca
Pennestrì, Francesco
Djafarrian, Reza
Mavromati, Maria
Kotsovolis, George
Pliakos, Ioannis
Di Filippo, Giacomo
Lazzari, Giovanni
Vaccaro, Carla
Izzo, Martina
Boi, Francesco
Brazzarola, Paolo
Feroci, Francesco
Demarchi, Marco Stefano
Papavramidis, Theodossios
Materazzi, Gabriele
Raffaelli, Marco
Calò, Pietro Giorgio
author_facet Canu, Gian Luigi
Medas, Fabio
Cappellacci, Federico
Rossi, Leonardo
Gjeloshi, Benard
Sessa, Luca
Pennestrì, Francesco
Djafarrian, Reza
Mavromati, Maria
Kotsovolis, George
Pliakos, Ioannis
Di Filippo, Giacomo
Lazzari, Giovanni
Vaccaro, Carla
Izzo, Martina
Boi, Francesco
Brazzarola, Paolo
Feroci, Francesco
Demarchi, Marco Stefano
Papavramidis, Theodossios
Materazzi, Gabriele
Raffaelli, Marco
Calò, Pietro Giorgio
author_sort Canu, Gian Luigi
collection PubMed
description BACKGROUND: Postoperative cervical haematoma represents an infrequent but potentially life-threatening complication of thyroidectomy. Since this complication is uncommon, the assessment of risk factors associated with its development is challenging. The main aim of this study was to identify the risk factors for its occurrence. METHODS: Patients undergoing thyroidectomy in seven high-volume thyroid surgery centers in Europe, between January 2020 and December 2022, were retrospectively analysed. Based on the onset of cervical haematoma, two groups were identified: Cervical Haematoma (CH) Group and No Cervical Haematoma (NoCH) Group. Univariate analysis was performed to compare these two groups. Moreover, employing multivariate analysis, all potential independent risk factors for the development of this complication were assessed. RESULTS: Eight thousand eight hundred and thirty-nine patients were enrolled: 8,561 were included in NoCH Group and 278 in CH Group. Surgical revision of haemostasis was performed in 70 (25.18%) patients. The overall incidence of postoperative cervical haematoma was 3.15% (0.79% for cervical haematomas requiring surgical revision of haemostasis, and 2.35% for those managed conservatively). The timing of onset of cervical haematomas requiring surgical revision of haemostasis was within six hours after the end of the operation in 52 (74.28%) patients. Readmission was necessary in 3 (1.08%) cases. At multivariate analysis, male sex (P < 0.001), older age (P < 0.001), higher BMI (P = 0.021), unilateral lateral neck dissection (P < 0.001), drain placement (P = 0.007), and shorter operative times (P < 0.001) were found to be independent risk factors for cervical haematoma. CONCLUSIONS: Based on our findings, we believe that patients with the identified risk factors should be closely monitored in the postoperative period, particularly during the first six hours after the operation, and excluded from outpatient surgery.
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spelling pubmed-105771662023-10-17 Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study) Canu, Gian Luigi Medas, Fabio Cappellacci, Federico Rossi, Leonardo Gjeloshi, Benard Sessa, Luca Pennestrì, Francesco Djafarrian, Reza Mavromati, Maria Kotsovolis, George Pliakos, Ioannis Di Filippo, Giacomo Lazzari, Giovanni Vaccaro, Carla Izzo, Martina Boi, Francesco Brazzarola, Paolo Feroci, Francesco Demarchi, Marco Stefano Papavramidis, Theodossios Materazzi, Gabriele Raffaelli, Marco Calò, Pietro Giorgio Front Surg Surgery BACKGROUND: Postoperative cervical haematoma represents an infrequent but potentially life-threatening complication of thyroidectomy. Since this complication is uncommon, the assessment of risk factors associated with its development is challenging. The main aim of this study was to identify the risk factors for its occurrence. METHODS: Patients undergoing thyroidectomy in seven high-volume thyroid surgery centers in Europe, between January 2020 and December 2022, were retrospectively analysed. Based on the onset of cervical haematoma, two groups were identified: Cervical Haematoma (CH) Group and No Cervical Haematoma (NoCH) Group. Univariate analysis was performed to compare these two groups. Moreover, employing multivariate analysis, all potential independent risk factors for the development of this complication were assessed. RESULTS: Eight thousand eight hundred and thirty-nine patients were enrolled: 8,561 were included in NoCH Group and 278 in CH Group. Surgical revision of haemostasis was performed in 70 (25.18%) patients. The overall incidence of postoperative cervical haematoma was 3.15% (0.79% for cervical haematomas requiring surgical revision of haemostasis, and 2.35% for those managed conservatively). The timing of onset of cervical haematomas requiring surgical revision of haemostasis was within six hours after the end of the operation in 52 (74.28%) patients. Readmission was necessary in 3 (1.08%) cases. At multivariate analysis, male sex (P < 0.001), older age (P < 0.001), higher BMI (P = 0.021), unilateral lateral neck dissection (P < 0.001), drain placement (P = 0.007), and shorter operative times (P < 0.001) were found to be independent risk factors for cervical haematoma. CONCLUSIONS: Based on our findings, we believe that patients with the identified risk factors should be closely monitored in the postoperative period, particularly during the first six hours after the operation, and excluded from outpatient surgery. Frontiers Media S.A. 2023-10-02 /pmc/articles/PMC10577166/ /pubmed/37850042 http://dx.doi.org/10.3389/fsurg.2023.1278696 Text en © 2023 Canu, Medas, Cappellacci, Rossi, Gjeloshi, Sessa, Pennestrì, Djafarrian, Mavromati, Kotsovolis, Pliakos, Di Filippo, Lazzari, Vaccaro, Izzo, Boi, Brazzarola, Feroci, Demarchi, Papavramidis, Materazzi, Raffaelli, Calò and REDHOT Study Collaborative Group. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Canu, Gian Luigi
Medas, Fabio
Cappellacci, Federico
Rossi, Leonardo
Gjeloshi, Benard
Sessa, Luca
Pennestrì, Francesco
Djafarrian, Reza
Mavromati, Maria
Kotsovolis, George
Pliakos, Ioannis
Di Filippo, Giacomo
Lazzari, Giovanni
Vaccaro, Carla
Izzo, Martina
Boi, Francesco
Brazzarola, Paolo
Feroci, Francesco
Demarchi, Marco Stefano
Papavramidis, Theodossios
Materazzi, Gabriele
Raffaelli, Marco
Calò, Pietro Giorgio
Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)
title Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)
title_full Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)
title_fullStr Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)
title_full_unstemmed Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)
title_short Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (REDHOT study)
title_sort risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy: a retrospective, multicenter, international analysis (redhot study)
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577166/
https://www.ncbi.nlm.nih.gov/pubmed/37850042
http://dx.doi.org/10.3389/fsurg.2023.1278696
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