Sepsis and septic shock in patients undergoing thyroidectomy: Incidence, risk factors, and outcomes

Authors

Usama Waqar, Aga Khan UniversityFollow
Namrah Aziz, Aga Khan UniversityFollow
Ahmad Areeb Chaudhry, Aga Khan UniversityFollow
Haissan Iftikhar, University Hospitals Birmingham, United Kingdom
Nadia Jivani, Aga Khan UniversityFollow
Syed Akbar Abbas, Aga Khan UniversityFollow

Document Type

Article

Department

Medical College Pakistan; Medicine; Otolaryngology, Head and Neck Surgery

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.

Comments

Issue is not provided by the author/publisher.

Publication (Name of Journal)

The Journal of Surgical Research

DOI

10.1016/j.jss.2024.03.021

Recommended Citation

Waqar, U., Aziz, N., Chaudhry, A. A., Iftikhar, H., Jivani, N., Abbas, S. A. (2024). Sepsis and septic shock in patients undergoing thyroidectomy: Incidence, risk factors, and outcomes. The Journal of Surgical Research, 298, 160-168.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_mc/432