Postoperative respiratory failure after thyroid and parathyroid surgery: analysis of national surgical quality improvement program

Head Neck. 2012 Mar;34(3):321-7. doi: 10.1002/hed.21723. Epub 2011 Mar 11.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Parathyroid Diseases / complications
  • Parathyroid Diseases / pathology
  • Parathyroid Diseases / surgery*
  • Parathyroidectomy / adverse effects*
  • Quality Improvement
  • Respiratory Insufficiency / epidemiology*
  • Risk Factors
  • Thyroid Diseases / complications
  • Thyroid Diseases / pathology
  • Thyroid Diseases / surgery*
  • Thyroidectomy / adverse effects*
  • United States