Patient selection: thyroidectomy
Outcome: hematoma requiring return to the operating room
The most important risk factor on multivariate analysis was preoperative anticoagulation (odds ratio 19).
Other risk factors from multivariate analysis:
(1) perioperative corticosteroid therapy
(2) thyroiditis
(3) smoking
(4) bilateral thyroidectomy
(5) postoperative elevation of the systolic blood pressure
(6) high operative blood loss
where:
• Leyre et al reported that anticoagulation or antiplatelet therapy did not increase the risk for hematoma formation.
• In the univariate analysis use of hemostatic agents and placement of a drain were risk factors. These could have been associated with high operative blood loss.
• When anticoagulants were stopped and restarted would influence the risk of bleeding.
• The need for corticosteroid therapy suggests either severe thyroiditis or adrenal insufficiency. Adrenal insufficiency and thyroiditis could be seen in polyendocrine autoimmune disorders.
