Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery: a nested case-control study
Purpose Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidect...
Gespeichert in:
| Veröffentlicht in: | LANGENBECK'S ARCHIVES OF SURGERY 2019, Vol.404 (7), p.815-823 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 823 |
|---|---|
| container_issue | 7 |
| container_start_page | 815 |
| container_title | LANGENBECK'S ARCHIVES OF SURGERY |
| container_volume | 404 |
| creator | Salem, Farhad Allahyar Bergenfelz, A. Nordenström, E. Dahlberg, J. Hessman, O. Lundgren, C. I. Almquist, M. |
| description | Purpose
Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidectomy. This study aimed to investigate this issue using a national population-based register.
Material and method
A nested case-control study on patients registered in the Swedish national register for endocrine surgery (SQRTPA) was performed. Patients with postoperative bleeding were matched 1:1 by age and gender to controls. Additional information on cases and controls was obtained from attending surgeons using a questionnaire. Risk factors for postoperative bleeding were evaluated with logistic regression and are presented as odds ratios (ORs) with 95% confidence intervals (CIs). The time of bleeding in relation to surgery was also investigated.
Results
There were 9494 operations, and 174 (1.8%) of them involved postoperative bleeding. In the whole cohort, patients with postoperative bleeding were older, 58 (46–69) vs. 49 (37–62) years, than patients without,
p
|
| doi_str_mv | 10.1007/s00423-019-01836-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_475555</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2315969185</sourcerecordid><originalsourceid>FETCH-LOGICAL-c678t-bb3bf587efd3a489b026d5481a7c7a24091c1fdd099db7619e06806f0518d6373</originalsourceid><addsrcrecordid>eNp9Uk1v1DAUjBCIlsIf4IB85NCAv-LEHJCqUj6klbgAV8uxX7LpZuNgJwt746fztrtd6KG19GTrvZnxWJ4se8noG0Zp-TZRKrnIKdNYlVC5fJSdMimKnMuCPT6epTjJnqV0TSlVpZZPsxPBSsmoYKfZn6uN7Wc7dUNLYpdWpLFuCjGRJkQSIYffYx8izsNA_AxkCmQMaQoj7JobIAO4FVnC2k5hbYltJohkWm5j6DxJc2whbt8Ri7A0gSfOJshdGKYYepKm2W-fZ08a2yd4cdjPsu8fr75dfs4XXz99ubxY5E6V1ZTXtaiboiqh8cLKSteUK1_IitnSlZZLqpljjfdUa1-XimmgqqKqoQWrvBKlOMvyvW76BeNcmzF2axu3JtjOHForPIGRZYEL8fpe_BiD_0e6JTLJZaXQCHIX93L7ecSqsXYcJcHVJXeG2oLh1Q03mtXUcGu18nVTF6AftN6iHLbaGzUhmOI76-f34j90Py5MiK2ZZyMp50Ih_P0ejtg1eAf4O7a_--A7k6FbmjZsjNK0KooKBV4fBGL4OeNHm3WXHPS9HSDMyXDBCq00q3bW-B7qYkgpQnO8hlGzC7XZh9pgqM1NqI1E0qv_DR4ptylGgDg8GEcDRs5chzkOGKeHZP8CaEwIUQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2315969185</pqid></control><display><type>article</type><title>Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery: a nested case-control study</title><source>SWEPUB Freely available online</source><source>SpringerLink Journals - AutoHoldings</source><creator>Salem, Farhad Allahyar ; Bergenfelz, A. ; Nordenström, E. ; Dahlberg, J. ; Hessman, O. ; Lundgren, C. I. ; Almquist, M.</creator><creatorcontrib>Salem, Farhad Allahyar ; Bergenfelz, A. ; Nordenström, E. ; Dahlberg, J. ; Hessman, O. ; Lundgren, C. I. ; Almquist, M.</creatorcontrib><description>Purpose
Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidectomy. This study aimed to investigate this issue using a national population-based register.
Material and method
A nested case-control study on patients registered in the Swedish national register for endocrine surgery (SQRTPA) was performed. Patients with postoperative bleeding were matched 1:1 by age and gender to controls. Additional information on cases and controls was obtained from attending surgeons using a questionnaire. Risk factors for postoperative bleeding were evaluated with logistic regression and are presented as odds ratios (ORs) with 95% confidence intervals (CIs). The time of bleeding in relation to surgery was also investigated.
Results
There were 9494 operations, and 174 (1.8%) of them involved postoperative bleeding. In the whole cohort, patients with postoperative bleeding were older, 58 (46–69) vs. 49 (37–62) years, than patients without,
p
< 0.01. Male patients had a higher risk of bleeding, OR 2.18 (95% CI 1.58–2.99). In the case-control cohort, drain was an independent risk factor for bleeding, OR 1.64 (1.05–2.57). Two-thirds of patients bled within 6 h after surgery. The incidence of bleeding after 24 h was 10%.
Conclusion
High age, male gender, and drain are independent risk factors for bleeding after thyroid surgery. Even with careful patient selection, prolonged observation might be necessary in thyroid surgery.</description><identifier>ISSN: 1435-2443</identifier><identifier>ISSN: 1435-2451</identifier><identifier>EISSN: 1435-2451</identifier><identifier>DOI: 10.1007/s00423-019-01836-4</identifier><identifier>PMID: 31741031</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>80 and over ; Abdominal Surgery ; Adult ; adverse effects ; Age Factors ; Aged ; Ambulatory Surgical Procedures ; Cardiac Surgery ; Case-Control Studies ; Clinical Medicine ; etiology ; Female ; General Surgery ; Hematoma ; Humans ; Kirurgi ; Klinisk medicin ; Male ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Medicine ; Medicine & Public Health ; Middle Aged ; Neck ; Odds Ratio ; Original ; Original Article ; Postoperative bleeding ; Postoperative Complications ; Postoperative neck hematoma ; Postoperative neck hematoma, risk factors ; Registries ; Reoperation ; Risk Factors ; Sex Factors ; Surgery ; Symptom Assessment ; Thoracic Surgery ; Thyroid surgery ; Thyroidectomy ; Traumatic Surgery ; Vascular Surgery</subject><ispartof>LANGENBECK'S ARCHIVES OF SURGERY, 2019, Vol.404 (7), p.815-823</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c678t-bb3bf587efd3a489b026d5481a7c7a24091c1fdd099db7619e06806f0518d6373</citedby><cites>FETCH-LOGICAL-c678t-bb3bf587efd3a489b026d5481a7c7a24091c1fdd099db7619e06806f0518d6373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00423-019-01836-4$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00423-019-01836-4$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,780,784,885,4023,27922,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31741031$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-402236$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/331625$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/64ecb72c-0a51-47f2-91b0-2aa96dbfb5e9$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:142486091$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Salem, Farhad Allahyar</creatorcontrib><creatorcontrib>Bergenfelz, A.</creatorcontrib><creatorcontrib>Nordenström, E.</creatorcontrib><creatorcontrib>Dahlberg, J.</creatorcontrib><creatorcontrib>Hessman, O.</creatorcontrib><creatorcontrib>Lundgren, C. I.</creatorcontrib><creatorcontrib>Almquist, M.</creatorcontrib><title>Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery: a nested case-control study</title><title>LANGENBECK'S ARCHIVES OF SURGERY</title><addtitle>Langenbecks Arch Surg</addtitle><addtitle>Langenbecks Arch Surg</addtitle><description>Purpose
Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidectomy. This study aimed to investigate this issue using a national population-based register.
Material and method
A nested case-control study on patients registered in the Swedish national register for endocrine surgery (SQRTPA) was performed. Patients with postoperative bleeding were matched 1:1 by age and gender to controls. Additional information on cases and controls was obtained from attending surgeons using a questionnaire. Risk factors for postoperative bleeding were evaluated with logistic regression and are presented as odds ratios (ORs) with 95% confidence intervals (CIs). The time of bleeding in relation to surgery was also investigated.
Results
There were 9494 operations, and 174 (1.8%) of them involved postoperative bleeding. In the whole cohort, patients with postoperative bleeding were older, 58 (46–69) vs. 49 (37–62) years, than patients without,
p
< 0.01. Male patients had a higher risk of bleeding, OR 2.18 (95% CI 1.58–2.99). In the case-control cohort, drain was an independent risk factor for bleeding, OR 1.64 (1.05–2.57). Two-thirds of patients bled within 6 h after surgery. The incidence of bleeding after 24 h was 10%.
Conclusion
High age, male gender, and drain are independent risk factors for bleeding after thyroid surgery. Even with careful patient selection, prolonged observation might be necessary in thyroid surgery.</description><subject>80 and over</subject><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>adverse effects</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Ambulatory Surgical Procedures</subject><subject>Cardiac Surgery</subject><subject>Case-Control Studies</subject><subject>Clinical Medicine</subject><subject>etiology</subject><subject>Female</subject><subject>General Surgery</subject><subject>Hematoma</subject><subject>Humans</subject><subject>Kirurgi</subject><subject>Klinisk medicin</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neck</subject><subject>Odds Ratio</subject><subject>Original</subject><subject>Original Article</subject><subject>Postoperative bleeding</subject><subject>Postoperative Complications</subject><subject>Postoperative neck hematoma</subject><subject>Postoperative neck hematoma, risk factors</subject><subject>Registries</subject><subject>Reoperation</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Surgery</subject><subject>Symptom Assessment</subject><subject>Thoracic Surgery</subject><subject>Thyroid surgery</subject><subject>Thyroidectomy</subject><subject>Traumatic Surgery</subject><subject>Vascular Surgery</subject><issn>1435-2443</issn><issn>1435-2451</issn><issn>1435-2451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>D8T</sourceid><recordid>eNp9Uk1v1DAUjBCIlsIf4IB85NCAv-LEHJCqUj6klbgAV8uxX7LpZuNgJwt746fztrtd6KG19GTrvZnxWJ4se8noG0Zp-TZRKrnIKdNYlVC5fJSdMimKnMuCPT6epTjJnqV0TSlVpZZPsxPBSsmoYKfZn6uN7Wc7dUNLYpdWpLFuCjGRJkQSIYffYx8izsNA_AxkCmQMaQoj7JobIAO4FVnC2k5hbYltJohkWm5j6DxJc2whbt8Ri7A0gSfOJshdGKYYepKm2W-fZ08a2yd4cdjPsu8fr75dfs4XXz99ubxY5E6V1ZTXtaiboiqh8cLKSteUK1_IitnSlZZLqpljjfdUa1-XimmgqqKqoQWrvBKlOMvyvW76BeNcmzF2axu3JtjOHForPIGRZYEL8fpe_BiD_0e6JTLJZaXQCHIX93L7ecSqsXYcJcHVJXeG2oLh1Q03mtXUcGu18nVTF6AftN6iHLbaGzUhmOI76-f34j90Py5MiK2ZZyMp50Ih_P0ejtg1eAf4O7a_--A7k6FbmjZsjNK0KooKBV4fBGL4OeNHm3WXHPS9HSDMyXDBCq00q3bW-B7qYkgpQnO8hlGzC7XZh9pgqM1NqI1E0qv_DR4ptylGgDg8GEcDRs5chzkOGKeHZP8CaEwIUQ</recordid><startdate>2019</startdate><enddate>2019</enddate><creator>Salem, Farhad Allahyar</creator><creator>Bergenfelz, A.</creator><creator>Nordenström, E.</creator><creator>Dahlberg, J.</creator><creator>Hessman, O.</creator><creator>Lundgren, C. I.</creator><creator>Almquist, M.</creator><general>Springer Berlin Heidelberg</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>ACNBI</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>DF2</scope><scope>ZZAVC</scope><scope>F1U</scope><scope>AGCHP</scope><scope>D95</scope></search><sort><creationdate>2019</creationdate><title>Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery: a nested case-control study</title><author>Salem, Farhad Allahyar ; Bergenfelz, A. ; Nordenström, E. ; Dahlberg, J. ; Hessman, O. ; Lundgren, C. I. ; Almquist, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c678t-bb3bf587efd3a489b026d5481a7c7a24091c1fdd099db7619e06806f0518d6373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>80 and over</topic><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>adverse effects</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Ambulatory Surgical Procedures</topic><topic>Cardiac Surgery</topic><topic>Case-Control Studies</topic><topic>Clinical Medicine</topic><topic>etiology</topic><topic>Female</topic><topic>General Surgery</topic><topic>Hematoma</topic><topic>Humans</topic><topic>Kirurgi</topic><topic>Klinisk medicin</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neck</topic><topic>Odds Ratio</topic><topic>Original</topic><topic>Original Article</topic><topic>Postoperative bleeding</topic><topic>Postoperative Complications</topic><topic>Postoperative neck hematoma</topic><topic>Postoperative neck hematoma, risk factors</topic><topic>Registries</topic><topic>Reoperation</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Surgery</topic><topic>Symptom Assessment</topic><topic>Thoracic Surgery</topic><topic>Thyroid surgery</topic><topic>Thyroidectomy</topic><topic>Traumatic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Salem, Farhad Allahyar</creatorcontrib><creatorcontrib>Bergenfelz, A.</creatorcontrib><creatorcontrib>Nordenström, E.</creatorcontrib><creatorcontrib>Dahlberg, J.</creatorcontrib><creatorcontrib>Hessman, O.</creatorcontrib><creatorcontrib>Lundgren, C. I.</creatorcontrib><creatorcontrib>Almquist, M.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SWEPUB Uppsala universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Uppsala universitet</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Göteborgs universitet</collection><collection>SWEPUB Lunds universitet full text</collection><collection>SWEPUB Lunds universitet</collection><jtitle>LANGENBECK'S ARCHIVES OF SURGERY</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Salem, Farhad Allahyar</au><au>Bergenfelz, A.</au><au>Nordenström, E.</au><au>Dahlberg, J.</au><au>Hessman, O.</au><au>Lundgren, C. I.</au><au>Almquist, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery: a nested case-control study</atitle><jtitle>LANGENBECK'S ARCHIVES OF SURGERY</jtitle><stitle>Langenbecks Arch Surg</stitle><addtitle>Langenbecks Arch Surg</addtitle><date>2019</date><risdate>2019</risdate><volume>404</volume><issue>7</issue><spage>815</spage><epage>823</epage><pages>815-823</pages><issn>1435-2443</issn><issn>1435-2451</issn><eissn>1435-2451</eissn><abstract>Purpose
Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidectomy. This study aimed to investigate this issue using a national population-based register.
Material and method
A nested case-control study on patients registered in the Swedish national register for endocrine surgery (SQRTPA) was performed. Patients with postoperative bleeding were matched 1:1 by age and gender to controls. Additional information on cases and controls was obtained from attending surgeons using a questionnaire. Risk factors for postoperative bleeding were evaluated with logistic regression and are presented as odds ratios (ORs) with 95% confidence intervals (CIs). The time of bleeding in relation to surgery was also investigated.
Results
There were 9494 operations, and 174 (1.8%) of them involved postoperative bleeding. In the whole cohort, patients with postoperative bleeding were older, 58 (46–69) vs. 49 (37–62) years, than patients without,
p
< 0.01. Male patients had a higher risk of bleeding, OR 2.18 (95% CI 1.58–2.99). In the case-control cohort, drain was an independent risk factor for bleeding, OR 1.64 (1.05–2.57). Two-thirds of patients bled within 6 h after surgery. The incidence of bleeding after 24 h was 10%.
Conclusion
High age, male gender, and drain are independent risk factors for bleeding after thyroid surgery. Even with careful patient selection, prolonged observation might be necessary in thyroid surgery.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31741031</pmid><doi>10.1007/s00423-019-01836-4</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1435-2443 |
| ispartof | LANGENBECK'S ARCHIVES OF SURGERY, 2019, Vol.404 (7), p.815-823 |
| issn | 1435-2443 1435-2451 1435-2451 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_475555 |
| source | SWEPUB Freely available online; SpringerLink Journals - AutoHoldings |
| subjects | 80 and over Abdominal Surgery Adult adverse effects Age Factors Aged Ambulatory Surgical Procedures Cardiac Surgery Case-Control Studies Clinical Medicine etiology Female General Surgery Hematoma Humans Kirurgi Klinisk medicin Male Medical and Health Sciences Medicin och hälsovetenskap Medicine Medicine & Public Health Middle Aged Neck Odds Ratio Original Original Article Postoperative bleeding Postoperative Complications Postoperative neck hematoma Postoperative neck hematoma, risk factors Registries Reoperation Risk Factors Sex Factors Surgery Symptom Assessment Thoracic Surgery Thyroid surgery Thyroidectomy Traumatic Surgery Vascular Surgery |
| title | Evaluating risk factors for re-exploration due to postoperative neck hematoma after thyroid surgery: a nested case-control study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T11%3A40%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evaluating%20risk%20factors%20for%20re-exploration%20due%20to%20postoperative%20neck%20hematoma%20after%20thyroid%20surgery:%20a%20nested%20case-control%20study&rft.jtitle=LANGENBECK'S%20ARCHIVES%20OF%20SURGERY&rft.au=Salem,%20Farhad%20Allahyar&rft.date=2019&rft.volume=404&rft.issue=7&rft.spage=815&rft.epage=823&rft.pages=815-823&rft.issn=1435-2443&rft.eissn=1435-2451&rft_id=info:doi/10.1007/s00423-019-01836-4&rft_dat=%3Cproquest_swepu%3E2315969185%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2315969185&rft_id=info:pmid/31741031&rfr_iscdi=true |