Background: The risk-benefit analysis of any operation is influenced by its perioperative complications. Our objective was to examine the relationship between preoperative clinical characteristics and postoperative respiratory failure (PRF: mechanical ventilation for >48 hours after surgery or reintubation) within 30 days of thyroid and parathyroid surgeries.
Methods: American College of Surgeons' multicenter, prospective, National Surgical Quality Improvement Program (NSQIP) datasets (2007/2008) were used. Multivariable logistic regression was performed.
Results: Eighty-three of 20,778 (0.4%) patients developed PRF. Comparing patients who developed PRF to those who did not, 30-day mortality was seen in 13 of 83 versus 11 of 20,695 patients (p < .0001); and mean length of stay (LOS) was 9.1 (±9.5) days versus 1.1 (±1.6) days (p < .0001). Multivariable analysis demonstrated preoperative pneumonia, dependent functional status, dyspnea, dialysis dependence, hypertension, advanced age, and combined thyroid and parathyroid surgery as risk factors for PRF.
Conclusion: PRF after thyroid and parathyroid surgeries is uncommon, but associated with significantly increased 30-day morbidity and mortality.
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