Incidence, risk factors and outcomes of urinary tract infections among patients undergoing thyroidectomy: insights from the ACS-NSQIP
Waqar, Usama Ahmed, Warda Fazal, Zoha Zahid Chaudhry, Ahmad Areeb Iftikhar, Haissan Ziauddin, Afsheen Abbas, Syed Akbar
Waqar, Usama
Ahmed, Warda
Fazal, Zoha Zahid
Chaudhry, Ahmad Areeb
Iftikhar, Haissan
Ziauddin, Afsheen
Abbas, Syed Akbar
Affiliation
Other Contributors
Publication date
2025-01-10
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Urinary tract infections (UTIs) represent a rare postoperative complication following thyroidectomy. This study aimed to assess the clinicodemographic factors associated with the development of UTIs and subsequent outcomes among patients undergoing thyroidectomy. This retrospective study used the National Surgical Quality Improvement Program (NSQIP) database to analyze patients who underwent thyroidectomy from 2005 to 2019. Multivariable logistic regression models were used to identify risk factors and associations of UTIs with postoperative morbidity and mortality. In a cohort of 180,373 identified thyroidectomy patients, 0.28% contracted a UTI. Significant risk factors associated with UTIs included age > 60 years (adjusted odds ratio [OR] 2.187, 95% confidence interval [CI] 1.618-2.956), female gender (OR 1.767, 95% CI 1.372-2.278), American Society of Anesthesiologists (ASA) Classification 3 to 5 (OR 1.463, 95% CI 1.185-1.805), partially (OR 4.267, 95% CI 2.510-7.253) or totally dependent functional health status (OR 9.658, 95% CI 4.170-22.370), pulmonary disease (OR1.907, 95% CI 1.295-2.808), chronic steroid therapy (OR 1.649, 95% CI 1.076-2.527), inpatient procedure (OR 1.507, 95% CI 1.251-1.814), and operative time > 150 minutes (OR 1.449, 95% CI 1.027-2.044). Additionally, UTIs were independently associated with postoperative complications, including pulmonary, vascular, or cardiac complication; stroke; acute renal failure; infectious complications; sepsis; septic shock; pneumonia; prolonged length of stay; unplanned reoperation; and mortality. While UTIs are rare after thyroidectomy, they carry a significant burden on patient outcomes. Preoperative optimization of comorbidities and reducing operative times may help mitigate the risk of UTIs. Optimized care for postoperative UTI patients is also recommended to prevent complications and improve outcomes.
Citation
Waqar U, Ahmed W, Fazal ZZ, Chaudhry AA, Iftikhar H, Ziauddin A, Abbas SA. Incidence, Risk Factors and Outcomes of Urinary Tract Infections among Patients Undergoing Thyroidectomy: Insights from the ACS-NSQIP. Int Arch Otorhinolaryngol. 2025 Jan 10;29(1):1-10. doi: 10.1055/s-0044-1788769.
Type
Article