Preoperative thyroid hormone replacement independently predicts operative morbidity and length of stay following major abdominal surgery, with a 1.5-fold increased risk of serious morbidity and a 1.7-fold greater risk for serious sepsis.
Key Findings
Results
Preoperative thyroid hormone replacement was associated with a 1.5-fold increased risk of serious morbidity after major abdominal surgery on multivariate analysis.
Analysis was performed on 2700 patients enrolled in the Michigan Surgical Quality Collaborative (MSQC) at an academic institution over a 10-year period.
The 1.5-fold increased risk of serious morbidity was statistically significant (p = 0.01).
Multivariate analysis corrected for established predictors of operative morbidity.
The study design was a retrospective case series.
Results
Preoperative thyroid hormone replacement was associated with a 1.7-fold greater risk of serious sepsis.
The association between thyroid hormone replacement and serious sepsis was statistically significant (p = 0.04).
This finding was derived from multivariate analysis correcting for established predictors of operative morbidity.
The cohort included 2700 patients undergoing major abdominal surgery.
Results
Thyroid hormone replacement was associated with longer length of hospital stay.
The association between thyroid hormone replacement and longer length of stay was statistically significant (p < 0.001).
Open surgery was also independently associated with longer length of stay (p < 0.001).
Patients on thyroid hormone replacement were more likely to undergo open rather than minimally invasive surgery (p < 0.01).
Results
Patients on thyroid hormone replacement were more likely to undergo open rather than minimally invasive surgery.
The association between thyroid hormone replacement and open surgical approach was statistically significant (p < 0.01).
There was a high degree of missing data for surgical approach, with 31.1% missing data, limiting the strength of this finding.
Open surgery was independently associated with greater risk of serious morbidity (p = 0.003) and longer length of stay (p < 0.001).
Results
Open surgery was independently associated with greater risk of serious morbidity and longer length of stay.
Open surgery was associated with greater risk of serious morbidity (p = 0.003).
Open surgery was associated with longer length of stay (p < 0.001).
This finding suggests that surgical approach may partially mediate the relationship between thyroid hormone replacement and perioperative complications.
Haring C, Heft Neal M, Jaffe C, Shuman A, Rosko A, Spector M. (2024). Association of preoperative thyroid hormone replacement with perioperative complications after major abdominal surgery.. American journal of surgery. https://doi.org/10.1016/j.amjsurg.2024.01.018