Same-day discharge is not associated with increased readmissions or complications after thyroid operations

Surgery. 2020 Jan;167(1):117-123. doi: 10.1016/j.surg.2019.06.054. Epub 2019 Sep 30.

Abstract

Background: Overnight hospitalization after thyroid surgery has been a widely adopted practice because of the concern for complications such as hypocalcemia and hematoma. Same-day discharge, however, has become popular in recent years.

Methods: The American College of Surgeons National Surgical Quality Improvement Program Targeted Thyroidectomy database (2016-2017) was used to identify patients who underwent thyroid resections. A 1:1 propensity score matching was used to match patients who were discharged on postoperative day 0 and those discharged on postoperative days 1 or 2. Multivariable logistic regression models were constructed to assess the association between discharge timing and postoperative outcomes.

Results: Of the 10,502 patients, 2,776 (26.4%) were discharged on postoperative day 0, and 7,726 (73.6%) were discharged on postoperative days 1 or 2. After propensity score matching, 1,977 matched pairs were created. In this matched cohort, the rates of readmission were similar when comparing patients discharged on postoperative day 0 with those discharged on postoperative days 1 or 2 (odds ratio 1.26, 95% confidence interval 0.78-2.05). Likewise, no differences were observed in the rates of surgical site infection, clinically severe hypocalcemia, neck hematoma, or recurrent laryngeal nerve injury.

Conclusion: In a national cohort of patients undergoing thyroid surgery, same-day discharge was not associated with greater rates of readmission or complications when compared with discharge 1 or 2 days after thyroid surgery.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Surgical Procedures / adverse effects*
  • Ambulatory Surgical Procedures / methods
  • Ambulatory Surgical Procedures / standards
  • Cohort Studies
  • Elective Surgical Procedures / adverse effects*
  • Elective Surgical Procedures / methods
  • Elective Surgical Procedures / standards
  • Female
  • Hematoma / epidemiology
  • Hematoma / etiology
  • Hematoma / prevention & control
  • Humans
  • Hypocalcemia / epidemiology
  • Hypocalcemia / etiology
  • Hypocalcemia / prevention & control
  • Length of Stay*
  • Male
  • Middle Aged
  • Neck
  • Patient Discharge / standards*
  • Patient Discharge / statistics & numerical data
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Postoperative Period
  • Practice Guidelines as Topic
  • Risk Factors
  • Thyroidectomy / adverse effects*
  • Thyroidectomy / methods
  • Thyroidectomy / standards