甲状腺切除术后急诊室就诊及再入院情况：来自内分泌外科协作质量改进项目（CESQIP）的评估
Post-thyroidectomy emergency room visits and readmissions: Assessment from the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP).
作者信息
Taye Aida, Inabnet William B, Pan Stephanie, Carty Sally E, Cotton Travis, Czako Peter, Doherty Gerard, Gauger Paul, Hanks John, McAneny David, Milas Mira, Perrier Nancy, Rosen Jennifer, Schneider David F, Sharma Jyotirmay, Siperstein Allan, Sosa Julie Ann
机构信息
Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Surgery, University of Kentucky, Lexington, KY, USA.
出版信息
Am J Surg. 2020 Oct;220(4):813-820. doi: 10.1016/j.amjsurg.2020.02.036. Epub 2020 Feb 19.
BACKGROUND
This study analyzed independent factors associated with post-thyroidectomy Emergency Room (ER) visits and Hospital Readmissions (HR).
METHODS
This is a retrospective review from the CESQIP registry of 8381 thyroidectomy patients by 173 surgeons at 46 institutions. A total of 7142 ER visits and 7265 HR were analyzed. Multivariable logistic regression analysis was performed to determine the risk factors for an ER visit or HR.
RESULTS
Within 30-days of surgery, rates of all ER visits were 3.4% (n = 250) and all HR were 2.3% (n = 170). Hypocalcemia was the reason for 21.9% of ER encounters and 36.4% of HR. BMI >40 kg/m was a risk factor for both ER visit (OR1.86) and HR (OR1.94). Surgical duration >3 h (OR2.63), and transection of recurrent laryngeal nerve (OR4.58) were risk factors for HR.
CONCLUSIONS
Strategies to decrease hypocalcemia and improve perioperative care of patients with BMI >40 kg/m may improve post-thyroidectomy outcome.
背景
本研究分析了与甲状腺切除术后急诊室（ER）就诊和医院再入院（HR）相关的独立因素。
方法
这是一项对46家机构的173名外科医生在CESQIP登记处登记的8381例甲状腺切除术患者进行的回顾性研究。共分析了7142次ER就诊和7265次HR。进行多变量逻辑回归分析以确定ER就诊或HR的危险因素。
结果
在术后30天内，所有ER就诊率为3.4%（n = 250），所有HR为2.3%（n = 170）。低钙血症是21.9%的ER就诊和36.4%的HR的原因。BMI>40 kg/m是ER就诊（OR 1.86）和HR（OR 1.94）的危险因素。手术时间>3小时（OR 2.63）和喉返神经横断（OR 4.58）是HR的危险因素。
结论
降低低钙血症以及改善BMI>40 kg/m患者围手术期护理的策略可能会改善甲状腺切除术后的结局。
Zotero 插件