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Risk factors for prolonged hospitalization and readmission after total thyroidectomy in children: Associations with surgical subspecialty

Published:October 08, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.09.052

      Highlights

      • Pediatric general surgeons perform most of the total thyroidectomies in NSQIP-P hospitals.
      • Prolonged hospitalization is more frequent after total thyroidectomy by pediatric ENT.
      • Postoperative readmissions are similar across pediatric and adult surgeons.
      • Opportunities may exist to improve outcomes with respect to resource utilization.

      Abstract

      Background

      Total thyroidectomy (TT) in children is performed by pediatric general surgeons (P-GS), pediatric otolaryngologists (P-ENT), or adult GS/ENT. This study evaluated short-term pediatric TT outcomes, focusing on surgical subspecialties.

      Methods

      Pediatric (<18 years) TT with/without central limited lymph node dissection (CLND) between 2015 and 2020 were obtained from the National Surgical Quality Improvement Program-Pediatric database. Risk factors for prolonged hospitalization (PH,>2 days) and 30-day readmission were investigated with multivariate logistic regression.

      Results

      Of 1535 patients, 14% had PH and 2% were readmitted. PH rates for P-ENT vs. P-GS vs. adult were 21% vs. 11% vs. 10%, respectively. Adjusted risk of PH was higher for P-ENT (OR 1.70, p = 0.003) but similar for P-GS/adult. There was no difference for risk of readmission by subspecialty.

      Conclusion

      PH is more likely after pediatric TT performed by P-ENT, as compared to P-GS or adult surgeons. While TT may be performed safely by individual subspecialties, collaboration across specialties may further optimize outcomes.
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