Post-thyroidectomy emergency room visits and readmissions: Assessment from the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP)

Aida Taye; William B Inabnet 3rd; Stephanie Pan; Sally E Carty; Travis Cotton; Peter Czako; Gerard Doherty; Paul Gauger; John Hanks; David McAneny; Mira Milas; Nancy Perrier; Jennifer Rosen; David F Schneider; Jyotirmay Sharma; Allan Siperstein; Julie Ann Sosa

doi:10.1016/j.amjsurg.2020.02.036

Post-thyroidectomy emergency room visits and readmissions: Assessment from the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP)

Am J Surg. 2020 Oct;220(4):813-820. doi: 10.1016/j.amjsurg.2020.02.036. Epub 2020 Feb 19.

Authors

Aida Taye¹, William B Inabnet 3rd², Stephanie Pan³, Sally E Carty⁴, Travis Cotton⁵, Peter Czako⁶, Gerard Doherty⁷, Paul Gauger⁸, John Hanks⁹, David McAneny¹⁰, Mira Milas¹¹, Nancy Perrier¹², Jennifer Rosen¹³, David F Schneider¹⁴, Jyotirmay Sharma¹⁵, Allan Siperstein¹⁶, Julie Ann Sosa¹⁷

Affiliations

¹ Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: [email protected].
² Department of Surgery, University of Kentucky, Lexington, KY, USA. Electronic address: [email protected].
³ Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: [email protected].
⁴ Department of Surgery, University of Pittsburgh School of Medicine at University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address: [email protected].
⁵ Department of Surgery, Brown University Warren Alpert School of Medicine at University Surgical Associates, Providence, RI, USA. Electronic address: [email protected].
⁶ Department of Surgery, Oakland University William Beaumont School of Medicine at Royal Oak Surgical Associates, Royal Oak, MI, USA. Electronic address: [email protected].
⁷ Department of Surgery, Harvard Medical School at Brigham and Women's Hospital, Boston, MA, USA. Electronic address: [email protected].
⁸ Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA. Electronic address: [email protected].
⁹ Department of Surgery, University of Virginia School of Medicine at University of Virginia Health Systems, Charlottesville, VA, USA. Electronic address: [email protected].
¹⁰ Department of Surgery, Boston University School of Medicine at Boston Medical Center, Boston, MA, USA. Electronic address: [email protected].
¹¹ Department of Surgery, University of Arizona College of Medicine at Banner-University Medical Center, Phoenix, AZ, USA. Electronic address: [email protected].
¹² Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: [email protected].
¹³ Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: [email protected].
¹⁴ Department of Surgery, University of Wisconsin School of Medicine, Madison, WI, USA. Electronic address: [email protected].
¹⁵ Department of Surgery, Emory University School of Medicine at Emory University Hospital, Atlanta, USA. Electronic address: [email protected].
¹⁶ Department of Surgery, Cleveland Clinic, Cleveland, OH, USA. Electronic address: [email protected].
¹⁷ Department of Surgery, University of California San Francisco-UCSF, San Francisco, CA, USA. Electronic address: [email protected].

PMID: 32115176
DOI: 10.1016/j.amjsurg.2020.02.036

Abstract

Background: This study analyzed independent factors associated with post-thyroidectomy Emergency Room (ER) visits and Hospital Readmissions (HR).

Methods: This is a retrospective review from the CESQIP registry of 8381 thyroidectomy patients by 173 surgeons at 46 institutions. A total of 7142 ER visits and 7265 HR were analyzed. Multivariable logistic regression analysis was performed to determine the risk factors for an ER visit or HR.

Results: Within 30-days of surgery, rates of all ER visits were 3.4% (n = 250) and all HR were 2.3% (n = 170). Hypocalcemia was the reason for 21.9% of ER encounters and 36.4% of HR. BMI >40 kg/m² was a risk factor for both ER visit (OR1.86) and HR (OR1.94). Surgical duration >3 h (OR2.63), and transection of recurrent laryngeal nerve (OR4.58) were risk factors for HR.

Conclusions: Strategies to decrease hypocalcemia and improve perioperative care of patients with BMI >40 kg/m² may improve post-thyroidectomy outcome.

Keywords: Emergency room visits; Outcomes; Quality; Readmissions; Thyroidectomy.

MeSH terms

Adult
Aged
Emergency Service, Hospital / statistics & numerical data*
Facilities and Services Utilization / statistics & numerical data*
Female
Humans
Male
Middle Aged
Patient Readmission / statistics & numerical data*
Postoperative Complications / epidemiology*
Quality Improvement
Retrospective Studies
Risk Factors
Thyroidectomy*
United States