TY - JOUR
T1 - The Impact of Diabetes on Morbidity and Mortality Following Thyroidectomy
AU - Patel, Roshan V.
AU - Randhawa, Avneet
AU - Randhawa, Karandeep S.
AU - Aftab, Owais M.
AU - Khawaja, Imran M.
AU - Hegazin, Michael
AU - Eloy, Jean Anderson
AU - Fang, Christina H.
N1 - Publisher Copyright:
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2023/12
Y1 - 2023/12
N2 - Objectives: To explore the association between diabetes and outcomes in thyroidectomy patients. Methods: This retrospective cohort analysis used the 2015–2017 American College of Surgeons National Surgery Quality Improvement Program database. Current Procedural Terminology (CPT) codes were used to identify thyroidectomy cases (60210, 60212, 60220, 60225, 60240, 60252, 60254, 60260, 60270, and 60271). Demographics, comorbidities, and complication incidences were compared between diabetic and nondiabetic patients using Pearson's chi-square test/Fisher's exact test as appropriate. The independent effect of diabetes on outcomes was analyzed using binary logistic regression. Results: A total of 47,776 (95.4%) nondiabetic and 2307 (4.6%) diabetic patients undergoing thyroidectomy were identified from 2015 to 2017. Chi-square analysis demonstrated that diabetic patients had higher incidences of obesity (55.2% vs. 33.2%; p < 0.001), dyspnea (12.7% vs. 4.8%; p < 0.001), poor functional status (1.9% vs. 0.4%; p < 0.001), ventilator dependence (0.6% vs. 0.1%; p < 0.001), chronic obstructive pulmonary disease (COPD; 6.8% vs. 2.2%; p < 0.001), congestive heart failure (1.1% vs. 0.3%; p < 0.001), acute renal failure (0.3% vs. 0.0%; p < 0.001), hypertension (79.2% vs. 32.4%; p < 0.001), dialysis (2.0% vs. 0.4%; p < 0.001), open wound (1.1% vs. 0.1%; p < 0.001), steroid use (5.3% vs. 2.3%; p < 0.001), bleeding disorders (3.6% vs. 0.9%; p < 0.001), preoperative blood transfusions (0.2% vs. 0.0%; p = 0.001), and systemic sepsis (1.0% vs. 0.3%; p < 0.001). Demographic characteristics were significantly different between the cohorts including gender (p < 0.001), age (p < 0.001), race (p < 0.001), and Hispanic ethnicity (p = 0.033). After adjusting for these factors, logistic regression analyses showed that diabetes was associated with acute renal failure (OR: 5.836; 95% CI: 1.060–32.134; p = 0.043), wound disruption (OR: 6.194; 95% CI: 1.752–21.900; p = 0.005), prolonged length of stay (OR: 1.430; 95% CI: 1.261–1.622; p < 0.001), unplanned readmission (OR: 1.380; 95% CI: 1.096–1.737; p = 0.006), superficial incisional surgical site infections (OR: 0.240; 95% CI: 0.058–0.995; p = 0.049), urinary tract infection occurrences (OR: 2.173; 95% CI: 1.186–3.980; p = 0.012), organ space surgical site infection occurrences (OR: 3.322; 95% CI: 1.016–10.864; p = 0.047), pneumonia occurrences (OR: 2.091; 95% CI: 1.125–3.884; p = 0.020), any medical complication (OR: 1.697; 95% CI: 1.246–2.313; p = 0.001), and any complication (OR: 1.495; 95% CI: 1.136–1.968; p = 0.004). Conclusion: Diabetes mellitus is a significant factor associated with increased odds of complications following thyroidectomy. Level of Evidence: 3 Laryngoscope, 133:3628–3632, 2023.
AB - Objectives: To explore the association between diabetes and outcomes in thyroidectomy patients. Methods: This retrospective cohort analysis used the 2015–2017 American College of Surgeons National Surgery Quality Improvement Program database. Current Procedural Terminology (CPT) codes were used to identify thyroidectomy cases (60210, 60212, 60220, 60225, 60240, 60252, 60254, 60260, 60270, and 60271). Demographics, comorbidities, and complication incidences were compared between diabetic and nondiabetic patients using Pearson's chi-square test/Fisher's exact test as appropriate. The independent effect of diabetes on outcomes was analyzed using binary logistic regression. Results: A total of 47,776 (95.4%) nondiabetic and 2307 (4.6%) diabetic patients undergoing thyroidectomy were identified from 2015 to 2017. Chi-square analysis demonstrated that diabetic patients had higher incidences of obesity (55.2% vs. 33.2%; p < 0.001), dyspnea (12.7% vs. 4.8%; p < 0.001), poor functional status (1.9% vs. 0.4%; p < 0.001), ventilator dependence (0.6% vs. 0.1%; p < 0.001), chronic obstructive pulmonary disease (COPD; 6.8% vs. 2.2%; p < 0.001), congestive heart failure (1.1% vs. 0.3%; p < 0.001), acute renal failure (0.3% vs. 0.0%; p < 0.001), hypertension (79.2% vs. 32.4%; p < 0.001), dialysis (2.0% vs. 0.4%; p < 0.001), open wound (1.1% vs. 0.1%; p < 0.001), steroid use (5.3% vs. 2.3%; p < 0.001), bleeding disorders (3.6% vs. 0.9%; p < 0.001), preoperative blood transfusions (0.2% vs. 0.0%; p = 0.001), and systemic sepsis (1.0% vs. 0.3%; p < 0.001). Demographic characteristics were significantly different between the cohorts including gender (p < 0.001), age (p < 0.001), race (p < 0.001), and Hispanic ethnicity (p = 0.033). After adjusting for these factors, logistic regression analyses showed that diabetes was associated with acute renal failure (OR: 5.836; 95% CI: 1.060–32.134; p = 0.043), wound disruption (OR: 6.194; 95% CI: 1.752–21.900; p = 0.005), prolonged length of stay (OR: 1.430; 95% CI: 1.261–1.622; p < 0.001), unplanned readmission (OR: 1.380; 95% CI: 1.096–1.737; p = 0.006), superficial incisional surgical site infections (OR: 0.240; 95% CI: 0.058–0.995; p = 0.049), urinary tract infection occurrences (OR: 2.173; 95% CI: 1.186–3.980; p = 0.012), organ space surgical site infection occurrences (OR: 3.322; 95% CI: 1.016–10.864; p = 0.047), pneumonia occurrences (OR: 2.091; 95% CI: 1.125–3.884; p = 0.020), any medical complication (OR: 1.697; 95% CI: 1.246–2.313; p = 0.001), and any complication (OR: 1.495; 95% CI: 1.136–1.968; p = 0.004). Conclusion: Diabetes mellitus is a significant factor associated with increased odds of complications following thyroidectomy. Level of Evidence: 3 Laryngoscope, 133:3628–3632, 2023.
KW - NSQIP
KW - diabetes
KW - outcomes
KW - thyroidectomy
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U2 - 10.1002/lary.30902
DO - 10.1002/lary.30902
M3 - Article
C2 - 37470297
AN - SCOPUS:85165429135
SN - 0023-852X
VL - 133
SP - 3628
EP - 3632
JO - Laryngoscope
JF - Laryngoscope
IS - 12
ER -