Can we consider immediate complications after thyroidectomy as a quality metric of operation?

• Published in: Surgery Vol. 161; no. 1; pp. 156 - 165
• Main Authors: Lifante, Jean-Christophe, MD, PhD, Payet, Cécile, MPH, Ménégaux, Fabrice, MD, Sebag, Frédéric, MD, Kraimps, Jean-Louis, MD, Peix, Jean-Louis, MD, Pattou, François, MD, PhD, Colin, Cyrille, MD, PhD, Duclos, Antoine, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2017
• Subjects: Acute Disease; Adult; Chronic Disease; Clinical Competence; Cross-Sectional Studies; Female; France; Health Care Surveys; Hospitals, High-Volume; Humans; Hypoparathyroidism - epidemiology; Hypoparathyroidism - etiology; Incidence; Male; Outcome Assessment (Health Care); Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Prospective Studies; Risk Assessment; Surgeons - statistics & numerical data; Surgery; Thyroidectomy - adverse effects; Thyroidectomy - methods; Vocal Cord Paralysis - epidemiology; Vocal Cord Paralysis - etiology
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2016.04.049

Background Permanent recurrent laryngeal nerve palsy and hypoparathyroidism are 2 major complications after thyroid operation. Assuming that the rate of immediate complications can predict the permanent complication rate, some authors consider these complications as a valid metric for assessing the performance of individual surgeons. This study aimed to determine the correlation between rates of immediate and permanent complications after thyroidectomy at the surgeon level. Methods We conducted a prospective, cross-sectional study in 5 academic hospitals between April 2008 and December 2009. The correlation between the rates of immediate and permanent complications for each of the 22 participating surgeons was calculated using the Pearson correlation test (r). Results The study period included 3,605 patients. There was a fairly good correlation between rates of immediate and permanent recurrent laryngeal nerve palsy (r = 0.70, P  = .004), but no correlation was found for immediate and permanent hypoparathyroidism (r = 0.18, P  = .427). Conclusion The immediate hypoparathyroidism rate does not reflect the permanent hypoparathyroidism rate. Consequently, immediate hypoparathyroidism should not be used to assess the quality of thyroidectomy or to monitor the performance of surgeons.