Department of Endocrine Surgery, Endocrinology and Metabolism Institute, Cleveland Clinic, 9500 Euclid Avenue, Mail Code F20, Cleveland, OH, 44195, USA.
World J Surg. 2023 Jun;47(6):1373-1378. doi: 10.1007/s00268-023-06997-4. Epub 2023 Mar 29.
The coronavirus disease 19 (COVID-19) has had a profound impact on our healthcare system. Surgery in particular faced significant challenges related to allocation of resources and equitable patient selection, resulting in a delay in non-emergent procedures. We sought to study the impact of the COVID-19 pandemic on patient outcomes after thyroidectomy.
This was a cross-sectional study using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database that included all thyroidectomies from 2018 to 2020. The primary outcome evaluated was surgical outcomes during 2020, the first year of the pandemic, compared to years preceding the pandemic. Factors associated with adverse postoperative outcomes during the study period were included in a multivariate analysis.
The volume of thyroidectomy procedures in 2020 decreased 16.4% when compared to the preceding years. During 2020, there was a significant increase in mortality (0.14% vs. 0.07%, p = 0.03), unplanned intubation (0.45% vs. 0.27%, p < 0.01) and cardiac arrest (0.11% vs. 0.03%, p < 0.01), while other complications remained stable. Undergoing surgery in 2020 remained as a risk factor for mortality in a multivariate analysis (OR 2.4 95% CI 1.3-4.4).
The first year of the COVID-19 pandemic had a significant impact on outcomes after thyroidectomy resulting in increased mortality. As the world recovers, there will likely be an increase number of patients seeking care who were unable to obtain it during the pandemic. Close attention should be placed on the outcomes which were altered during the pandemic.
2019 年冠状病毒病（COVID-19）对我们的医疗体系产生了深远的影响。手术尤其面临着资源分配和公平选择患者方面的重大挑战，导致非紧急手术延迟。我们旨在研究 COVID-19 大流行对甲状腺切除术患者结局的影响。
这是一项使用美国外科医师学会国家外科质量改进计划（ACS-NSQIP）数据库的横断面研究，该数据库纳入了 2018 年至 2020 年期间所有甲状腺切除术。主要结局评估是大流行第一年 2020 年的手术结果，与大流行前的年份相比。研究期间与不良术后结局相关的因素纳入多变量分析。
与前几年相比，2020 年甲状腺切除术的数量减少了 16.4%。2020 年，死亡率（0.14%比 0.07%，p=0.03）、计划性插管（0.45%比 0.27%，p<0.01）和心脏骤停（0.11%比 0.03%，p<0.01）显著增加，而其他并发症保持稳定。多变量分析显示，2020 年手术仍然是死亡的危险因素（OR 2.4，95%CI 1.3-4.4）。
COVID-19 大流行的第一年对甲状腺切除术的结局产生了重大影响，导致死亡率增加。随着世界的复苏，可能会有更多在大流行期间无法获得治疗的患者寻求治疗。应密切关注大流行期间改变的结局。
