Mok et al identified factors predictive of a difficult thyroidectomy. This can help to identify a patient who may benefit from a more careful preoperative evaluation. The authors are from the University of Wisconsin in Madison.
Patient selection: difficult thyroidectomy
Criteria for difficult thyroidectomy: Thyroidectomy Difficulty Scale (TDS) >= 10
Parameters:
(1) hyperthyroidism
(2) antithyroglobulin antibodies
(3) serum thyroglobulin concentration
Parameter
Finding
Hazard Ratio
hyperthyroidism
absent
1
present
4.4
antithyroid antibody
absent
1
present
3.5
serum thyroglobulin
<= 150 ng/mL
1
> 150 ng/mL
2.6
where:
• 1 ng/mL is 1µg/L.
cumulative hazard ratio =
= PRODUCT(hazard ratios present)
Interpretation:
• minimum cumulative hazard ratio: 1
• maximum cumulative hazard ratio: 40
• The higher the cumulative hazard ratio the greater the risk of a difficult thyroidectomy.
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