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Risk Factors for Post-Thyroidectomy Bleeding: an Analysis of 19,657 Cases from a Single Institution

Journal of Endocrine Surgery 2020년 20권 4호 p.60 ~ 68
Lee Dawid, 백교림, 최준호, 김지수, 김정한,
소속 상세정보
 ( Lee Dawid ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
백교림 ( Back Kyo-Rim ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
최준호 ( Choe Jun-Ho ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김지수 ( Kim Jee-Soo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김정한 ( Kim Jung-Han ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery

Abstract


Purpose: Post-thyroidectomy bleeding (PTB) is rare but may be a life-threatening complication. This study investigated the incidence of and risk factors for postoperative bleeding after thyroid surgery.

Methods: The medical records of all patients who underwent thyroidectomy at Samsung Medical Center between November 1994 and July 2018 were reviewed retrospectively to identify any risk factors for PTB. Clinicopathological factors related to post-thyroidectomy bleeding were included in our analysis, and the association of potential risk factors with outcomes was tested by logistic regression analysis.

Results: Of 19,657 patients, PTB occurred in 132 (0.67%). In addition, 130 cases of PTB had emerged within 24 hours, while only 2 patients required re-operation after discharge. One patient expired due to hypoxic brain damage. A univariate analysis revealed that male sex (odds ratio [OR]=2.28, P<0.0001), chronic kidney disease (OR=5.26, P=0.02), the use of anti-hemorrhagic agents (OR=0.57, P=0.0017), and surgeon-specific factors (OR=3.4, P<0.0001) were significantly associated with PTB. However, upon multivariate analysis, only male sex (OR=2.34, P<0.0001) and surgeon-specific factors (OR=3.10, P<0.0001) were significant risk factors for PTB.

Conclusion: Male sex and surgeon-related factors significantly increased the risk of PTB. Since our study showed a tendency for PTB to increase within 24 hours of surgery, surgeons should look through whole surgical process or surgical techniques to minimize bleeding during the operation and conduct a close observation of all patients immediately after surgery.

키워드

Thyroidectomy; Post-thyroidectomy bleeding; Risk factors for post-thyroidectomy bleeding

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