Risk factors for post-thyroidectomy haemorrhage: a meta-analysis.
TLDR
A systematic review identified a number of risk factors for post-thyroidectomy haemorrhage, including older age, male sex, Graves' disease, antithrombotic agents use, bilateral operation, neck dissection and previous thyroid surgery.Abstract:
BACKGROUND Post-thyroidectomy haemorrhage is a rare but potentially life-threatening and unpredictable complication of thyroid surgery. In this study, we analysed the potential risk factors for the occurrence of post-thyroidectomy haemorrhage. METHODS The PubMed and SCIE databases were comprehensively searched for studies published before June 30, 2016. Studies on patients who underwent an open thyroidectomy with or without neck dissection were included, and RevMan 5.3 software was used to analyse the data. RESULTS Twenty-five studies and 424 563 patients were included in this meta-analysis, and post-thyroidectomy haemorrhage occurred in 6277 patients (incidence rate = 1.48%). The following variables were associated with an increased risk of post-thyroidectomy haemorrhage: older age (MD = 4.30, 95% CI = 3.09-5.52, P < 0.00001), male sex (OR = 1.73, 95% CI = 1.54-1.94, P < 0.00001), Graves' disease (OR = 1.76, 95% CI = 1.44-2.15, P < 0.00001), antithrombotic agents use (OR = 1.96, 95% CI 1.55-2.49, P < 0.00001), bilateral operation (OR = 1.71, 95% CI = 1.50-1.96, P < 0.00001), neck dissection (OR = 1.53, 95% CI = 1.11-2.11, P = 0.01) and previous thyroid surgery (OR = 1.62, 95% CI = 1.12-2.34, P = 0.01). Malignant tumours (OR = 1.07, 95% CI = 0.89-1.28, P = 0.46) and drainage device use (OR = 1.27, 95% CI = 0.74-2.18, P = 0.4) were not associated with post-thyroidectomy haemorrhage. CONCLUSION Our systematic review identified a number of risk factors for post-thyroidectomy haemorrhage, including older age, male sex, Graves' disease, antithrombotic agents use, bilateral operation, neck dissection and previous thyroid surgery. Early control of modifiable risk factors could improve patient outcomes and satisfaction.read more
Citations
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The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults
Kepal N. Patel,Linwah Yip,Carrie C. Lubitz,Elizabeth G. Grubbs,Barbra S. Miller,Wen T. Shen,Peter Angelos,Herbert Chen,Gerard M. Doherty,Thomas J. Fahey,Electron Kebebew,Virginia A. LiVolsi,Nancy D. Perrier,Jennifer A. Sipos,Julie Ann Sosa,David L. Steward,Ralph P. Tufano,Christopher R. McHenry,Sally E. Carty +18 more
TL;DR: These clinical guidelines analyze the indications for thyroidectomy as well as its definitions, technique, morbidity, and outcomes and were created to assist clinicians in the optimal surgical management of thyroid disease.
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Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management.
TL;DR: A higher risk profile for significant post-operative bleeding cannot be determined in patients undergoing thyroid surgery and protocols to reduce the risk of bleeding and for the early detection and management of bleed are developed.
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May predictors of difficulty in thyroid surgery increase the incidence of complications? Prospective study with the proposal of a preoperative score.
Valerio D'Orazi,Valerio D'Orazi,Andrea Sacconi,Silvia Trombetta,Menelaos Karpathiotakis,Menelaos Karpathiotakis,Daniele Pichelli,Enrico Di Lorenzo,Alice Ortensi,Urciuoli P,Marco Biffoni,Andrea Ortensi +11 more
TL;DR: Predictors of difficulty in thyroidectomy did not affect morbidity rates, as suggested by previous studies, but only operative times, which were significantly increased in patients with higher score, allow the fundamental role of a systematic use of optical magnification and microsurgical technique to be confirmed.
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Post-thyroidectomy bleeding: analysis of risk factors from a national registry.
TL;DR: In this article, the authors reviewed the best available UK data to evaluate a recent change in this recommendation and found that the highest risk for bleeding occurred following total thyroidectomy in men, but overall bleeding was unpredictable.
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Narrative review of management of thyroid surgery complications.
Shan Jin,Iwao Sugitani +1 more
TL;DR: In this article, the authors discuss the prevention, recognition and therapy of intraoperative and postoperative complications in thyroid surgery and discuss the potential negative effects that complications may have on patients' quality of life.
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