Meltzer Charles, Klau Marc, Gurushanthaiah Deepak, Tsai Joanne, Meng Di, Radler Linda, Sundang Alvina
The Permanente Medical Group, Santa Rosa, California, USA
Southern California Permanente Medical Group, Anaheim, California, USA.
Otolaryngol Head Neck Surg. 2016 May;154(5):789-96. doi: 10.1177/0194599816636842. Epub 2016 Mar 22.
To test our hypothesis that general and thyroid surgery-specific complications, mortality, and postdischarge utilization for patients undergoing outpatient and inpatient thyroid and parathyroid surgery would not differ when outpatient status was defined as discharge within 8 hours of surgery completion.
Retrospective observational cohort, 2008 to 2013.
Kaiser Permanente Northern California and Kaiser Permanente Southern California.
We used a robust set of variables and propensity score methods to match 2362 patients undergoing hemithyroidectomy, total thyroidectomy, or parathyroidectomy surgery as outpatients to 2362 patients undergoing the same procedures as inpatients. Outcomes assessed were 30-day rates of complications, emergency department visits, all-cause hospital readmissions, and mortality.
After matching, no statistically significant differences between inpatients and outpatients were found for complication rates or postdischarge utilization. After matching, there was no statistically significant difference between inpatients and outpatients in hematoma rates, which were 0.55% in both groups. In the matched-pair groups, 2 deaths occurred among inpatients (0.09%) and none occurred among outpatients (0.00%), a difference that was not statistically significant.
Discharge within 8 hours after completion of thyroid and parathyroid surgery is as safe as inpatient surgery.
检验我们的假设，即当门诊状态定义为手术完成后8小时内出院时，接受门诊和住院甲状腺及甲状旁腺手术的患者的一般及甲状腺手术特定并发症、死亡率和出院后利用率不会有差异。
2008年至2013年的回顾性观察队列研究。
北加利福尼亚州凯撒医疗集团和南加利福尼亚州凯撒医疗集团。
我们使用了一组丰富的变量和倾向评分方法，将2362例行半甲状腺切除术、全甲状腺切除术或甲状旁腺切除术的门诊患者与2362例行相同手术的住院患者进行匹配。评估的结果包括30天内的并发症发生率、急诊就诊率、全因再入院率和死亡率。
匹配后，住院患者和门诊患者在并发症发生率或出院后利用率方面未发现统计学上的显著差异。匹配后，住院患者和门诊患者的血肿发生率无统计学显著差异，两组均为0.55%。在配对组中，住院患者中有2例死亡（0.09%），门诊患者中无死亡（0.00%），差异无统计学意义。
甲状腺和甲状旁腺手术后8小时内出院与住院手术一样安全。
