Outcomes of Thyroidectomy During the COVID-19 Pandemic: A NSQIP Analysis

• Published in: World journal of surgery Vol. 47; no. 6; pp. 1373 - 1378
• Main Authors: Romero-Velez, Gustavo, Noureldine, Salem I., Burneikis, Talia A., Bletsis, Panagiotis, Parmer, Megan, Siperstein, Allan
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2023; Springer Nature B.V
• Subjects: Abdominal Surgery; Cardiac Surgery; Complications; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; Cross-Sectional Studies; General Surgery; Humans; Medicine; Medicine & Public Health; Mortality; Multivariate analysis; Original Scientific Report; Pandemics; Patients; Postoperative Complications - etiology; Quality control; Quality Improvement; Resource allocation; Retrospective Studies; Risk Factors; Surgery; Surgical outcomes; Thoracic Surgery; Thyroidectomy; Thyroidectomy - adverse effects; Vascular Surgery; Viral diseases
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-023-06997-4

Background The coronavirus disease 19 (COVID-19) has had a profound impact on our healthcare system. Surgery in particular faced significant challenges related to allocation of resources and equitable patient selection, resulting in a delay in non-emergent procedures. We sought to study the impact of the COVID-19 pandemic on patient outcomes after thyroidectomy. Methods This was a cross-sectional study using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database that included all thyroidectomies from 2018 to 2020. The primary outcome evaluated was surgical outcomes during 2020, the first year of the pandemic, compared to years preceding the pandemic. Factors associated with adverse postoperative outcomes during the study period were included in a multivariate analysis. Results The volume of thyroidectomy procedures in 2020 decreased 16.4% when compared to the preceding years. During 2020, there was a significant increase in mortality (0.14% vs. 0.07%, p  = 0.03), unplanned intubation (0.45% vs. 0.27%, p  < 0.01) and cardiac arrest (0.11% vs. 0.03%, p  < 0.01), while other complications remained stable. Undergoing surgery in 2020 remained as a risk factor for mortality in a multivariate analysis (OR 2.4 95% CI 1.3–4.4). Conclusion The first year of the COVID-19 pandemic had a significant impact on outcomes after thyroidectomy resulting in increased mortality. As the world recovers, there will likely be an increase number of patients seeking care who were unable to obtain it during the pandemic. Close attention should be placed on the outcomes which were altered during the pandemic.