良性甲状腺疾病手术治疗结果的种族差异。
Racial disparities in surgical outcomes for benign thyroid disease.
机构信息
Department of Surgery, Yale University School of Medicine, New Haven, CT, 06520, USA.
Department of Surgery, Yale University School of Medicine, New Haven, CT, 06520, USA.
出版信息
Am J Surg. 2020 Nov;220(5):1219-1224. doi: 10.1016/j.amjsurg.2020.06.054. Epub 2020 Jul 6.
INTRODUCTION
Previous studies have shown racial disparities in surgical outcomes in malignant thyroid disease. We hypothesize that minority groups have a higher incidence of postoperative complications following surgery for benign thyroid disease.
METHODS
Using NSQIP (2016-2017), patients (>17 years) undergoing thyroid surgery for benign disease were identified. Outcomes included neck hematoma, recurrent laryngeal nerve (RLN) injury, and hypocalcemia. Multivariate analysis was performed controlling for patient factors.
RESULTS
6817 patients were identified. Postoperative outcomes were neck hematoma (2.0%), RLN injury (5.2%), and significant hypocalcemia (4.9%). Compared to White patients, Black patients had higher chance of neck hematoma (OR 2.32, 95% CI 1.51-3.55) and RLN injury (OR 1.97, 95% CI 1.53-2.55) while Asian patients had significantly greater odds of RLN injury (OR 1.88, 95% CI 1.15-3.06).
CONCLUSION
Minority compared to White patients are more likely to have significant postoperative complications which indicates racial disparities in the surgical treatment for benign thyroid disease.
介绍
先前的研究表明，恶性甲状腺疾病的手术结果存在种族差异。我们假设，在因良性甲状腺疾病而接受手术的患者中，少数民族群体术后并发症的发生率更高。
方法
利用 NSQIP（2016-2017 年），确定了因良性疾病而行甲状腺手术的患者。研究结果包括颈部血肿、喉返神经（RLN）损伤和低钙血症。通过控制患者因素进行多变量分析。
结果
共确定了 6817 例患者。术后结果包括颈部血肿（2.0%）、RLN 损伤（5.2%）和明显的低钙血症（4.9%）。与白人患者相比，黑人患者发生颈部血肿（OR 2.32，95%CI 1.51-3.55）和 RLN 损伤（OR 1.97，95%CI 1.53-2.55）的几率更高，而亚洲患者发生 RLN 损伤的几率明显更高（OR 1.88，95%CI 1.15-3.06）。
结论
与白人患者相比，少数民族患者更有可能出现严重的术后并发症，这表明在良性甲状腺疾病的手术治疗中存在种族差异。
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