Skip to main content

Advertisement

SpringerLink
Log in

Same-Day Thyroidectomy: A Review of Practice Patterns and Outcomes for 1,168 Procedures in New York State

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

There has been a shift of procedures from the inpatient to the outpatient setting. Same-day thyroidectomy (SDT) has been reported in high-volume single-institution series, but few studies have evaluated its widespread use.

Methods

Patients undergoing thyroidectomy for benign and malignant thyroid disease were abstracted from the 2004 New York State inpatient (SID) and ambulatory surgery (SASD) databases. SDTs were discharged on the same day as their surgery. Patient and provider (surgeon and hospital volume) characteristics were associated with outcomes, including probability of SDT versus hospital admission and 30-day rehospitalization, by bivariate and multivariate analyses.

Results

A total of 6,762 thyroidectomies were identified; 17% (1,168) were SDTs. Patients undergoing SDT compared to thyroidectomy with admission were more often white (80 vs. 65%, P < 0.001), with private insurance (80 vs. 70%, P < 0.001) and fewer comorbidities (96 vs. 89% with Charlson scores of none/low, P < 0.001). SDT was performed more often by high-volume surgeons (48 vs. 31%, P < 0.001) and at high-volume hospitals (61 vs. 35%, P < 0.001). Rehospitalization rates of 1.4 and 2.4% were observed for SDT and inpatient thyroidectomy, respectively (P = NS). In multivariate analysis, thyroidectomy by a high-volume surgeon was associated with a higher chance of same-day discharge (odds ratio = 2.3, P < 0.001).

Conclusion

Nearly 20% of thyroidectomy patients undergo SDT in New York State. They have different demographic and clinical characteristics than patients undergoing thyroidectomy who are admitted. There seem to be a few high-volume surgeons and centers with extensive SDT experience. More research is needed to explore optimized patient triage and patterns of referral to centers of excellence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Burkey SH, van Heerden JA, Thompson GB, et al. Reexploration for symptomatic hematomas after cervical exploration. Surgery. 2001;130:914–20.

    Article  PubMed  CAS  Google Scholar 

  2. Snyder SK, Hamid KS, Roberson CR et al (2010) Outpatient thyroidectomy is safe and reasonable: experience with more than 1,000 planned outpatient procedures. J Am Coll Surg. 210:575–82.

    Article  PubMed  Google Scholar 

  3. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.

    Article  PubMed  CAS  Google Scholar 

  4. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–9.

    Article  PubMed  CAS  Google Scholar 

  5. Calland JF, Tanaka K, Foley E, et al. Outpatient laparoscopic cholecystectomy: patient outcomes after implementation of a clinical pathway. Ann Surg. 2001;233:704–15.

    Article  PubMed  CAS  Google Scholar 

  6. Rosen MJ, Malm JA, Tarnoff M, Zuccala K, Ponsky JL. Cost-effectiveness of ambulatory laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2001;11:182–4.

    PubMed  CAS  Google Scholar 

  7. Leyre P, Desurmont T, Lacoste L, et al. Does the risk of compressive hematoma after thyroidectomy authorize 1-day surgery? Langenbecks Arch Surg. 2008;393:733–7.

    Article  PubMed  Google Scholar 

  8. Schwartz AE, Clark OH, Ituarte P, Lo Gerfo P. Therapeutic controversy: thyroid surgery—the choice. J Clin Endocrinol Metab. 1998;83:1097–105.

    Article  PubMed  CAS  Google Scholar 

  9. Samson PS, Reyes FR, Saludares WN, et al. Outpatient thyroidectomy. Am J Surg. 1997;173:499–503.

    Article  PubMed  CAS  Google Scholar 

  10. Spanknebel K, Chabot JA, DiGiorgi M, et al. Thyroidectomy using monitored local or conventional general anesthesia: an analysis of outpatient surgery, outcome and cost in 1,194 consecutive cases. World J Surg. 2006;30:813–24.

    Article  PubMed  Google Scholar 

  11. Stavrakis AI, Ituarte PH, Ko CY, Yeh MW. Surgeon volume as a predictor of outcomes in inpatient and outpatient endocrine surgery. Surgery. 2007;142:887–99.

    Article  PubMed  Google Scholar 

  12. Sosa JA, Mehta PJ, Wang TS, Yeo HL, Roman SA. Racial disparities in clinical and economic outcomes from thyroidectomy. Ann Surg. 2007;246:1083–91.

    Article  PubMed  Google Scholar 

  13. Dionigi G, Rovera F, Carrafiello G, Boni L, Dionigi R. Ambulatory thyroid surgery: need for stricter patient selection criteria. Int J Surg. 2008;6(Suppl 1):S19–21.

    Article  PubMed  Google Scholar 

  14. Smith CM, Yawn BP. Factors associated with appointment keeping in a family practice residency clinic. J Fam Pract. 1994;38:25–9.

    PubMed  CAS  Google Scholar 

  15. Xu KT, Borders TF. Characteristics of rural elderly people who bypass local pharmacies. J Rural Health. 2003;19:156–64.

    Article  PubMed  Google Scholar 

  16. Tuggle CT, Park LS, Roman S, Udelsman R, Sosa JA (2010) Rehospitalization among elderly patients with thyroid cancer after thyroidectomy are prevalent and costly. Ann Surg Oncol. 17(11):2816–23.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

C.T.T. was supported by a grant from the Doris Duke Charitable Foundation.

Conflict of Interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA

    Charles T. Tuggle BS, Sanziana Roman MD, Robert Udelsman MD & Julie Ann Sosa MA, MD

Authors
  1. Charles T. Tuggle BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sanziana Roman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert Udelsman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Julie Ann Sosa MA, MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sanziana Roman MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tuggle, C.T., Roman, S., Udelsman, R. et al. Same-Day Thyroidectomy: A Review of Practice Patterns and Outcomes for 1,168 Procedures in New York State. Ann Surg Oncol 18, 1035–1040 (2011). https://doi.org/10.1245/s10434-010-1398-0

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-010-1398-0

Keywords

Search

Navigation