Smoking is associated with adverse clinical outcomes after thyroidectomy: a 5-year retrospective analysis

• Published in: BMC endocrine disorders Vol. 25; no. 1; pp. 70 - 13
• Main Authors: Chen, Yue, Chen, Junxin, Huang, Yanrui, Ke, Weijian, Yu, Shuang, Liang, Weiwei, Xiao, Haipeng, Li, Yanbing, Guan, Hongyu
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.03.2025; BioMed Central; BMC
• Subjects: Adult; Aged; Care and treatment; Clinical outcomes; Codes; Comorbidity; Comparative analysis; Complications; Complications and side effects; Disease; Ethnicity; Family income; Female; Follow-Up Studies; Health aspects; Hospitals; Humans; Hypocalcemia; Hypomagnesemia; Male; Malignancy; Middle Aged; Mortality; Nonsmokers; Patient outcomes; Patients; Population; Postoperative; Postoperative complications; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prognosis; Regression analysis; Retrospective Studies; Risk Factors; Smokers; Smoking; Smoking - adverse effects; Statistics; Surgery; Thyroid; Thyroid cancer; Thyroid diseases; Thyroid Diseases - surgery; Thyroid gland; Thyroid Neoplasms - surgery; Thyroid nodule; Thyroidectomy; Thyroidectomy - adverse effects; Tobacco; Vitamin deficiency; United States; United States > US; Thyroid nodule; Thyroid cancer; Thyroidectomy; Postoperative complications; Smoking
• ISSN: 1472-6823; 1472-6823
• DOI: 10.1186/s12902-025-01901-8

Tobacco use has been confirmed to be a risk factor for postoperative complications, but the impact of smoking on adverse outcomes following thyroidectomy remains largely unknown. Using data spanning 2016-2020 from the National Inpatient Sample, patients aged ≥ 18 years who underwent thyroidectomy for thyroid malignancy or other thyroid disorders were identified and classified into two groups: current smokers and non-smokers. We compared outcome variables between the two groups via univariate analysis and adjusted multivariate logistic regression. The present study included 13,737 records of patients who underwent thyroidectomy, among whom 1,360 (9.90%) were identified as current smokers. After propensity score matching, logistic regression analysis suggested that smoking was associated with a heightened risk of unfavorable discharge (aOR = 1.27, 95% CI [1.05-1.54], P = 0.012), vocal dysfunction (aOR = 1.25, 95% CI [1.00-1.55], P = 0.049), hypocalcemia (aOR = 1.23, 95% CI [1.05-1.44], P = 0.010), hypomagnesemia (aOR = 1.58, 95% CI [1.19-2.09], P = 0.001), and respiratory complications (aOR = 1.39, 95% CI [1.16-1.68], P < 0.001). Similar results were observed in both patients who underwent thyroidectomy for thyroid malignancy and those who underwent thyroidectomy for other thyroid disorders when a stratified analysis by surgical indications was performed. Smoking is an independent risk factor for adverse clinical outcomes after thyroidectomy.