Population-Based Assessment of Complications following Surgery for Thyroid Cancer.

Population-Based Assessment of Complications following Surgery for Thyroid Cancer.

J Clin Endocrinol Metab. 2017 Apr 28;:

Authors: Papaleontiou M, Hughes DT, Guo C, Banerjee M, Haymart MR

Abstract
Context: As thyroid cancer incidence rises, more patients undergo thyroid surgery. Although post-operative complication rates have been reported in single institution studies, population-based data is limited.
Objective: Determine thyroid cancer surgery complication rates and identify at-risk populations.
Design/Setting/Patients: Using the Surveillance, Epidemiology, and End Results-Medicare database, we evaluated general complications within 30 days and thyroid surgery specific complications within one year in 27,912 patients who underwent surgery for differentiated or medullary thyroid cancer between 1998-2011. Multivariable analyses of patient characteristics associated with post-operative complications were performed.
Main Outcome Measures: General and thyroid surgery specific complications.
Results: Overall, 1820 (6.5%) patients developed general post-operative complications (fever, infection, hematoma, cardiopulmonary, thromboembolic events) and 3427 (12.3%) developed thyroid surgery specific complications (hypoparathyroidism/hypocalcemia, vocal cord/fold paralysis). In multivariable analyses, general and thyroid surgery specific complication rates were significantly higher in patients >65 years (OR 2.61, 95% CI 2.31-2.95; OR 3.12, 95% CI 2.85-3.42), those with a Charlson/Deyo comorbidity score of 1 (OR 2.40, 95% CI 1.66-3.49; OR 1.88, 95% CI 1.53-2.31) and ≥2 (OR 7.05, 95% CI 5.33-9.56; OR 3.62, 95% CI 3.11-4.25), and those with regional (OR 1.18, 95% CI 1.03-1.35; OR 1.31, 95% CI 1.19-1.45) or distant disease (OR 2.83, 95% CI 2.30-3.47; OR 1.85, 95% CI 1.54-2.21), respectively.
Conclusions: The rates of thyroid cancer surgery complications are higher than predicted, and patients with older age, more comorbidities and advanced disease are at greatest risk. This has implications for patients undergoing thyroid cancer surgery. Efforts to reduce complications are needed.

PMID: 28460061 [PubMed - as supplied by publisher]

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