A National Comparison of Postoperative Outcomes in Completion Thyroidectomy and Total Thyroidectomy

Objective To characterize and assess the non-thyroid-specific postoperative complications of completion thyroidectomy as compared with total thyroidectomy. Study Design Retrospective analysis: 2005 to 2017. Setting National Surgical Quality Improvement Program database. Subjects and Methods Patients aged >18 years receiving a completion or total thyroidectomy were eligible for inclusion. Patients not treated by otolaryngologists or general surgeons and with unknown demographic variables were excluded. Results A total of 70,638 patients were analyzed, representing 64,763 total thyroidectomies and 5875 completion thyroidectomies. The 30-day mortality rate was 0.1% for both procedures (P> .05). Overall, 1.7% and 1.4% of patients undergoing total and completion thyroidectomies experienced at least 1 complication (P> .05), while 1.2% and 0.9% had a postoperative medical complication (P= .0186), respectively. On multivariable analysis, patients undergoing total thyroidectomies were significantly more likely to return to the operating room (odds ratio [OR], 1.36; 95% CI, 1.04-1.80;P= .027) and to be readmitted (OR, 1.45; 95% CI, 1.16-1.81;P= .001). Adjusted analysis also demonstrated that patients undergoing total thyroidectomies were more likely to be inpatients (OR, 1.17; 95% CI, 1.11-1.24;P< .001), be treated by nonotolaryngologists (OR, 1.36; 95% CI, 1.29-1.45;P< .001), and smoke (OR, 1.22; 95% CI, 1.13-1.33;P< .001). Conclusion National data suggest that total and completion thyroidectomies are relatively safe procedures but that completion thyroidectomies are associated with lower rates of postoperative complications. These findings may play a role in determining treatment plans for patients and optimizing risk reduction.