title: Postoperative hematomas after thyroid surgery. Incidence and risk factors in our experience.
abstract: OBJECTIVE
  The aim of our study was to evaluate the incidence and timing of postoperative bleeding and to identify the potential aetiological factors of cervical hematomas complicating thyroid surgery.
  
  
  METHODS
  Between September 2002 and December 2009, 2559 patients were operated on in Department of Surgery, University Hospital of Cagliari. 2257 total thyroidectomies, 191 total thyroidectomies associated to lymphadenectomy, 83 total thyroidectomies associated to parathyroidectomy, 24 thyroid lobectomies and 4 lobectomies associated to parathyroidectomy were performed.
  
  
  RESULTS
  35 Patients (1.36%) developed a postoperative hematoma, 32 of whom (1.25%) needed a surgical revision. Male sex seemed to have a greater risk: 13 men (2.79% of all males) vs. 19 women (0.90% of all female cases) had to undergo haemostasis revision (p = 0.00204). 16 of 32 patients (50%) who underwent surgical revision had hypertension; incidence of hematoma was 2.09% in patients with hypertension and 0.89% in patients without it (p = 0.02112).
  
  
  CONCLUSIONS
  It is generally difficult to predict which patients are at risk for the development of a hematoma after thyroid surgery. The most intense postoperative monitoring is necessary during the first six hours but hematomas occurring after are not rare.
  
  
  CONCLUSIONS
  Postoperative hematoma remains a rare but potentially life-threatening complication. Early recognition with immediate intervention is the key to the management of this complication. Because of the possibly long interval between the initial operation and the hematoma development, ambulatory and one-day thyroid surgery is not advisable.
authors.affiliation: Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università degli Studi di Cagliari, Italy. pgcalo@unica.it
authors.forename: Pietro Giorgio
authors.initials: PG
authors.lastname: Calò
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pisano
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piga
authors.forename: Fabio
authors.initials: F
authors.lastname: Medas
authors.forename: Alberto
authors.initials: A
authors.lastname: Tatti
authors.forename: Marcello
authors.initials: M
authors.lastname: Donati
authors.forename: Angelo
authors.initials: A
authors.lastname: Nicolosi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006406:Hematoma / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D013965:Thyroidectomy / Q000009:adverse effects*; D055815:Young Adult