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甲状腺切除术和甲状旁腺切除术的结果。

Outcomes after thyroidectomy and parathyroidectomy.

机构信息

Department of Surgery, Creighton University, Omaha, Nebraska, USA.

出版信息

Head Neck. 2012 Apr;34(4):477-84. doi: 10.1002/hed.21757. Epub 2011 Jun 2.

Abstract

BACKGROUND

Previous reports on postoperative outcomes following thyroid and parathyroid surgery are limited by relatively small sample size. We report 30-day outcomes following thyroid and parathyroid surgery and analyze factors affecting length of stay (LOS) and postoperative adverse events (AEs).

METHODS

The multicenter, prospective, National Surgical Quality Improvement Program (NSQIP) datasets (2007/2008) were used. Multivariable logistic regression and analysis of covariance (ANCOVA) were performed.

RESULTS

Patients undergoing thyroidectomy, parathyroidectomy, or both were identified (n = 13,380, 6154, 1535, respectively). Thirty-day mortality was 0.08%, 0.16%, and 0.2%, respectively; 30-day morbidity was 3.50%, 3.02%, and 4.04%, respectively. Mean LOS values were 1.1 ± 1.4, 1.1 ± 2.1, and 1.4 ± 3.1 days, respectively. Congestive heart failure, dependent functional status, dialysis dependence, and chronic corticosteroid use were significantly associated with increased LOS and postoperative AE.

CONCLUSIONS

Morbidity and mortality rates following thyroid and parathyroid surgery are low. These data could be used by third-party interests, and surgeons should be aware of them to ensure their outcomes are in the national norm.

摘要

背景

以往关于甲状腺和甲状旁腺手术后结果的报告受到样本量相对较小的限制。我们报告了甲状腺和甲状旁腺手术后 30 天的结果,并分析了影响住院时间(LOS)和术后不良事件(AE)的因素。

方法

使用多中心、前瞻性国家手术质量改进计划(NSQIP)数据集(2007/2008 年)。进行了多变量逻辑回归和协方差分析(ANCOVA)。

结果

确定了行甲状腺切除术、甲状旁腺切除术或两者的患者(n=13380、6154、1535 例)。30 天死亡率分别为 0.08%、0.16%和 0.2%;30 天发病率分别为 3.50%、3.02%和 4.04%。平均 LOS 值分别为 1.1±1.4、1.1±2.1 和 1.4±3.1 天。充血性心力衰竭、依赖功能状态、透析依赖和慢性皮质类固醇使用与 LOS 和术后 AE 增加显著相关。

结论

甲状腺和甲状旁腺手术后的发病率和死亡率较低。这些数据可以为第三方利益相关者所用,外科医生应了解这些数据,以确保其结果符合国家规范。

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