Campbell et al identified risk factors associated with hematoma following thyroidectomy. These can help to identify patients who may benefit from more aggressive management. The authors are from Brigham and Women's Hospital and 10 other institutions.


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



• 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.


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