Department of Surgery, University of California San Diego, San Diego, CA.
Department of Surgery, University of California San Diego, San Diego, CA.
Surgery. 2014 Aug;156(2):399-404. doi: 10.1016/j.surg.2014.03.015. Epub 2014 Mar 14.
Hematoma after thyroidectomy is a potentially lethal complication. We sought to evaluate risk factors for hematoma formation using the Nationwide Inpatient Sample. We hypothesized that certain risk factors could be identified and that this information would be useful to surgeons.
The Nationwide Inpatient Sample database was queried for patients who underwent thyroidectomy from 1998 to 2010. Bivariate analysis was used to compare patients with and without hematoma. Logistic regression was performed to identify important predictors of hematoma.
There were 150,012 patients. The rate of hematoma was 1.25%. Female sex and high-volume hospitals were important for decreased hematoma risk (odds ratio 0.61[0.54-0.69] and 0.71 [0.56-0.83], respectively). Black race, age >45 years, inflammatory thyroid disease, partial thyroidectomy, chronic kidney disease, and bleeding disorders increased the risk of hematoma (odds ratio 1.37, 1.44, 1.59, 1.69, 1.8, 3.38; respectively). Overall mortality was 0.32% for the entire group and 1.34% in patients with postoperative hematoma (P < .001). Patients with hematoma after thyroidectomy were 2.94 [1.76-4.9] times more likely to die than those without hematoma.
We identified risk factors associated with postoperative hematoma after thyroidectomy. Such information should be useful for surgeons for predicting patients at risk for this potentially lethal complication.
甲状腺手术后血肿是一种潜在的致命并发症。我们试图利用全国住院患者样本评估血肿形成的危险因素。我们假设可以确定某些危险因素，这些信息对外科医生有用。
从 1998 年至 2010 年，在全国住院患者样本数据库中查询接受甲状腺切除术的患者。采用双变量分析比较有血肿和无血肿的患者。采用逻辑回归分析确定血肿的重要预测因素。
共纳入 150012 例患者。血肿发生率为 1.25%。女性和高容量医院是降低血肿风险的重要因素（比值比分别为 0.61[0.54-0.69]和 0.71 [0.56-0.83]）。黑种人、年龄>45 岁、炎症性甲状腺疾病、甲状腺部分切除术、慢性肾脏病和出血性疾病增加了血肿的风险（比值比分别为 1.37、1.44、1.59、1.69、1.8、3.38）。总体死亡率为 0.32%，术后有血肿的患者为 1.34%（P<0.001）。甲状腺手术后有血肿的患者死亡的可能性是无血肿患者的 2.94 倍（1.76-4.9）。
我们确定了与甲状腺手术后血肿相关的危险因素。这些信息对预测有这种潜在致命并发症风险的患者对外科医生有用。
