Sepsis and septic shock in patients undergoing thyroidectomy: incidence, risk factors, and outcomes.
Waqar, Usama Aziz, Namrah Chaudhry, Ahmad Areeb Iftikhar, Haissan Jivani, Nadia Abbas, Syed Akbar
Waqar, Usama
Aziz, Namrah
Chaudhry, Ahmad Areeb
Iftikhar, Haissan
Jivani, Nadia
Abbas, Syed Akbar
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2024-04-13
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Abstract
Introduction: Postoperative sepsis represents a rare complication following thyroidectomy. We aimed to explore the incidence, risk factors, sources, and outcomes of postoperative sepsis and septic shock among adult patients undergoing thyroidectomy.
Methods: Data from the American College of Surgeons National Surgical Quality Improvement Program were used in this retrospective cohort study. Patients aged ≥18 y who underwent elective thyroidectomy between 2005 and 2019 were included. Multivariable binary logistic regression models were computed to explore risk factors and outcomes of 30-d sepsis and septic shock.
Results: Among the 180,373 included patients, 0.1% developed sepsis or septic shock. Male gender, low body mass index, American Society of Anesthesiologists classes 3-5, functional dependence, smoking, diabetes mellitus, pulmonary disease, inpatient surgery, malignant indication, clean-contaminated wound classification, and operation time ≥150 min were significant risk factors for development of sepsis or septic shock. Common infectious sources of sepsis included surgical site infections (29.6%), pneumonia (18.6%), urinary tract infections (16.2%), and multiple infections (6.9%). Patients with postoperative sepsis or septic shock were significantly more likely to develop complications, including wound disruption, stroke, cardiac and renal complications, thromboembolism, prolonged length of stay, unplanned reoperation, and mortality.
Conclusions: Sepsis is rare following thyroidectomy. Our study provides insight into risk factors and procedural characteristics which may contribute to the development of postoperative sepsis or septic shock in this population.
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Waqar U, Aziz N, Chaudhry AA, Iftikhar H, Jivani N, Abbas SA. Sepsis and Septic Shock in Patients Undergoing Thyroidectomy: Incidence, Risk Factors, and Outcomes. J Surg Res. 2024 Jun;298:160-168. doi: 10.1016/j.jss.2024.03.021. Epub 2024 Apr 17.
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