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Dependent status is a risk factor for complications after thyroidectomy

      Highlights

      • Functional dependent status has been associated with worse perioperative outcomes.
      • Dependent patients also have worse outcomes following thyroidectomies.
      • Outcomes included major complications and increased length of stay.

      Abstract

      Background

      Functional dependency has been associated with increased risk of adverse events following many surgical procedures. We hypothesized that dependent patients would have an increased risk of complications following thyroidectomy.

      Methods

      We performed a retrospective review of total thyroidectomies performed from 1/2012–12/2019 as identified by CPT codes using the National Surgical Quality Improvement Project (NSQIP) database. Functional dependent status was identified from within the NSQIP database with partially or totally dependent combined into the dependent group.

      Results

      A total of 64,978 patients were included, with 0.53% identified as functionally dependent (FD). Functional dependency was associated with an increased risk of wound disruption, pneumonia, UTI, stroke, cardiac arrest, PE/DVT, and sepsis/septic shock. Dependent patients had higher rates of unplanned intubation, ventilator use, and significant bleeding.
      On multivariate analysis, FD patients were more likely to suffer from major complications and have an increased length of stay.

      Conclusions

      Dependent status was associated with an increased risk of complications following thyroidectomy. Focused preoperative and disposition planning for these patients can help to minimize adverse outcomes and optimize resource utilization.

      Keywords

      Abbreviations:

      FD (Functionally Dependent), FI (Functionally Independent), NSQIP (National Surgical Quality Improvement Project), LOS (Length of Stay), BMI (Body Mass Index), ASA (American Society of Anesthesiology), ADL (Activities of Daily Living)
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