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Association of same-day discharge with hospital readmission after pediatric thyroidectomy

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Abstract

Background

Studies have demonstrated that same-day discharge (SDD) following thyroid resection is safe and feasible in adults but there are no similar studies in the pediatric age group. The purpose of this study is to evaluate the influence of SDD on 30-day readmission rates following thyroid surgery in pediatric patients.

Methods

This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program–Pediatric database to evaluate 30-day readmission rates among patients < 19 years of age who underwent thyroid resection between 2012 and 2017. Patients excluded were those discharged more than 2 days after surgery. The main exposure variable was SDD and the primary outcome was 30-day readmission. Secondary outcomes included wound complications, unplanned reoperation and death. Patient characteristics were compared using chi-squared testing and odds ratios for readmission were calculated using multivariate logistic regression.

Results

Of the 1125 patients (79% female, median age 15 years), 122 (11%) were discharged on the day of surgery. Total or near-total thyroidectomy represented the majority of operations (714, 63.5%) and patients undergoing these operations were less likely to be discharged on the same day as surgery compared to those undergoing thyroid lobectomy (4.3 vs. 22.1%, P < 0.001). Twenty-nine patients were readmitted within 30 days (3 in the same day group, 26 in the later group). There was no difference in the odds of readmission between the two groups (adjusted odds ratio in SDD compared to later discharge 1.04 [95% CI 0.29–3.75, P = 0.96; readmission rate, 2.46 vs. 2.59%). Wound complications were reported in two patients, both in the later discharge group.

Conclusion

Same-day discharge in pediatric patients undergoing thyroidectomy is not associated with an increase in 30-day readmissions or wound complications when compared to patients discharged 1 or 2 days after surgery. In selected patients, SDD may be an appropriate alternative to traditional overnight stay.

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Authors and Affiliations

  1. Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 1001 Main Street, Buffalo, NY, 14203, USA

    Jasmine Bhinder & David H. Rothstein

  2. Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA

    Kathleen Bethin & Lucy D. Mastrandrea

  3. Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, USA

    Moshim Kukar

  4. Department of Pediatric Surgery, John R. Oishei Children’s Hospital, Buffalo, USA

    David H. Rothstein

Authors
  1. Jasmine Bhinder
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  2. Kathleen Bethin
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  3. Moshim Kukar
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  4. Lucy D. Mastrandrea
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  5. David H. Rothstein
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Jasmine Bhinder & David Rothstein. The first draft of the manuscript was written by Jasmine Bhinder and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jasmine Bhinder.

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Bhinder, J., Bethin, K., Kukar, M. et al. Association of same-day discharge with hospital readmission after pediatric thyroidectomy. Pediatr Surg Int 37, 1259–1264 (2021). https://doi.org/10.1007/s00383-021-04927-w

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  • DOI: https://doi.org/10.1007/s00383-021-04927-w

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