Risk Factors for Post-Thyroidectomy Bleeding: an Analysis of 19,657 Cases from a Single Institution

Lee Dawid; Back Kyorim; Choe Jun-Ho; Kim Jee Soo; Kim Jung-Han

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저자정보: Lee Dawid (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University) Back Kyorim (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University) Choe Jun-Ho (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University) Kim Jee Soo (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University) Kim Jung-Han (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University)

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제20권 제4호

발행연도: 2020.1

수록면: 60 - 68 (9page)

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Purpose: Post-thyroidectomy bleeding (PTB) is rare but may be a life-threatening complication. This study investigated the incidence of and risk factors for postoperative bleeding after thyroid surgery. Methods: The medical records of all patients who underwent thyroidectomy at Samsung Medical Center between November 1994 and July 2018 were reviewed retrospectively to identify any risk factors for PTB. Clinicopathological factors related to post-thyroidectomy bleeding were included in our analysis, and the association of potential risk factors with outcomes was tested by logistic regression analysis. Results: Of 19,657 patients, PTB occurred in 132 (0.67%). In addition, 130 cases of PTB had emerged within 24 hours, while only 2 patients required re-operation after discharge. One patient expired due to hypoxic brain damage. A univariate analysis revealed that male sex (odds ratio [OR]=2.28, P<0.0001), chronic kidney disease (OR=5.26, P=0.02), the use of anti-hemorrhagic agents (OR=0.57, P=0.0017), and surgeon-specific factors (OR=3.4, P<0.0001) were significantly associated with PTB. However, upon multivariate analysis, only male sex (OR=2.34, P<0.0001) and surgeon-specific factors (OR=3.10, P<0.0001) were significant risk factors for PTB. Conclusion: Male sex and surgeon-related factors significantly increased the risk of PTB. Since our study showed a tendency for PTB to increase within 24 hours of surgery, surgeons should look through whole surgical process or surgical techniques to minimize bleeding during the operation and conduct a close observation of all patients immediately after surgery.

#Thyroidectomy #Post-thyroidectomy bleeding #Risk factors for post-thyroidectomy bleeding

참고문헌 (29)

참고문헌 신청

Rosenbaum MA / 2008 / Life-threatening neck hematoma complicating thyroid and parathyroid surgery / Am J Surg 195:339~343

Sanabria A / 2007 / Routine drainage after thyroid surgery--a meta-analysis / J Surg Oncol 96:273~280

Suzuki S / 2016 / Factors associated with neck hematoma after thyroidectomy: a retrospective analysis using a Japanese inpatient database / Medicine (Baltimore) 95:e2812

이형신 / 2009 / Patterns of Post-thyroidectomy Hemorrhage / Clinical and Experimental Otorhinolaryngology 2(2):72~77

Godballe C / 2009 / Post-thyroidectomy hemorrhage : a national study of patients treated at the Danish departments of ENT Head and Neck Surgery / Eur Arch Otorhinolaryngol 266:1945~1952

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Lee Dawid

소속기관 Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University