A National Comparison of Postoperative Outcomes in Completion Thyroidectomy and Total Thyroidectomy
Philip R. Brauer, C.A. Reddy, Brian B. Burkey, Eric Lamarre
Abstract
Objective To characterize and assess the non–thyroid‐specific postoperative complications of completion thyroidectomy as compared with total thyroidectomy. Study Design Retrospective analysis: 2005 to 2017. Setting National Surgical Quality Improvement Program database. Subjects and Methods Patients aged >18 years receiving a completion or total thyroidectomy were eligible for inclusion. Patients not treated by otolaryngologists or general surgeons and with unknown demographic variables were excluded. Results A total of 70,638 patients were analyzed, representing 64,763 total thyroidectomies and 5875 completion thyroidectomies. The 30‐day mortality rate was 0.1% for both procedures ( P >. 05). Overall, 1.7% and 1.4% of patients undergoing total and completion thyroidectomies experienced at least 1 complication ( P >. 05), while 1.2% and 0.9% had a postoperative medical complication ( P =. 0186), respectively. On multivariable analysis, patients undergoing total thyroidectomies were significantly more likely to return to the operating room (odds ratio [OR], 1.36; 95% CI, 1.04‐1.80; P =. 027) and to be readmitted (OR, 1.45; 95% CI, 1.16‐1.81; P =. 001). Adjusted analysis also demonstrated that patients undergoing total thyroidectomies were more likely to be inpatients (OR, 1.17; 95% CI, 1.11‐1.24; P <. 001), be treated by nonotolaryngologists (OR, 1.36; 95% CI, 1.29‐1.45; P <. 001), and smoke (OR, 1.22; 95% CI, 1.13‐1.33; P <. 001). Conclusion National data suggest that total and completion thyroidectomies are relatively safe procedures but that completion thyroidectomies are associated with lower rates of postoperative complications. These findings may play a role in determining treatment plans for patients and optimizing risk reduction.