I. I. Maizlin1, H. Chen2, R. T. Russell1 1University Of Alabama at Birmingham,Pediatric Surgery,Birmingham, Alabama, USA 2University Of Alabama at Birmingham,General Surgery,Birmingham, Alabama, USA
Introduction: Thyroid neoplasms are among the most common endocrine pathologies in the pediatric population and their incidence has increased over the last several decades. Many of these conditions require surgical resection. We aimed to determine pre-operative and intraoperative factors that affect unplanned post-operative readmission (UPOR) among pediatric patients undergoing thyroidectomy.
Methods: Utilizing the 2015 NSQIP-P Public-Use-File (first year to include these procedures), pediatric thyroidectomy patients were collated. We evaluated demographics, comorbidities, peri-operative variables and post-operative morbidities, performing a multivariate analysis comparing individuals that required UPOR within 30 days of surgery to those that did not.
Results: 658 pediatric thyroidectomies were identified, of whom 2.6% required UPOR. Following multivariate analysis, male gender (3.7%, p=0.027), African American race (5.7%, p=0.038) and pre-operative inpatient status (3.1%, p=0.015) were associated with increased rates of UPOR. Patients with thyroiditis were significantly more likely to have UPOR (4.4%, p=0.023). Similarly, higher UPOR rates were seen in patients with a history of asthma (8.3%, p=0.030), cardiac comorbidities (7.1%, p=0.001), developmental delay (3.6%, p=0.047) and hematological disorders (9.1%, p=0.021). In addition, figure 1 demonstrates that patients operated by general surgeons had a lower rate of UPOR (0.5%) when compared to otolaryngology surgeons (4.3%) (p=0.019), as well as lower rates of surgical site infections (p=0.041) and shorter operative times (p<0.001).
Conclusion: The number of children readmitted after thyroid surgery is low. Several factors, however, including underlying etiology of thyroid disease and surgeon subspecialty, highly determine the rate of unplanned post-operative readmission after thyroid surgery in children.
