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Risk factors for post-thyroidectomy haematoma

Published online by Cambridge University Press:  21 December 2015

M Perera*
Affiliation:
Department of Surgery, Western Health, Footscray, Australia
L Anabell
Affiliation:
Department of Surgery, Western Health, Footscray, Australia
D Page
Affiliation:
Department of Surgery, Western Health, Footscray, Australia
T Harding
Affiliation:
Department of Surgery, Western Health, Footscray, Australia
N Gnaneswaran
Affiliation:
Department of Surgery, Western Health, Footscray, Australia
S Chan
Affiliation:
Department of Surgery, Western Health, Footscray, Australia Academic Surgery, University of Melbourne, Victoria, Australia
*
Address for correspondence: Dr Marlon Perera, Department of Surgery, Western Health, Footscray, Victoria, Australia E-mail: [email protected]

Abstract

Background:

There has been increasing emphasis on performing ‘same-day’ or ‘out-patient’ thyroidectomy to reduce associated costs. However, acceptance has been limited by the risk of potentially life-threatening post-operative bleeding. This study aimed to review current rates of post-operative bleeding in a metropolitan teaching hospital and identify risk factors.

Method:

Medical records of patients undergoing thyroidectomy between January 2007 and March 2012 were reviewed retrospectively. Pre-operative, operative and pathological data, and post-operative complication data, were examined.

Results:

The study comprised 205 thyroidectomy cases. Mean age was 51.6 years (standard deviation = 14.74), with 80 per cent females. Unilateral thyroidectomy was performed in 81 cases (39.5 per cent) and total thyroidectomy was performed in 74 cases (36.1 per cent; 5.3 per cent with concomitant lymph node dissection). Nine patients (4.4 per cent) suffered post-operative bleeding, of which six required re-operation. Analysis showed that post-operative systolic blood pressure of 180 mmHg or greater was associated with post-operative bleeding (p = 0.003, chi-square test).

Conclusion:

Rates of significant post-operative bleeding are consistent with recent literature. Post-operative hypertension, diabetes and high post-operative drain output were identified as independent risk factors on multivariate analysis; when identified, these may be caveats to same-day discharge of thyroidectomy patients.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

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