title: Postoperative respiratory failure after thyroid and parathyroid surgery: analysis of national surgical quality improvement program.
abstract: BACKGROUND
  The risk-benefit analysis of any operation is influenced by its perioperative complications. Our objective was to examine the relationship between preoperative clinical characteristics and postoperative respiratory failure (PRF: mechanical ventilation for >48 hours after surgery or reintubation) within 30 days of thyroid and parathyroid surgeries.
  
  
  METHODS
  American College of Surgeons' multicenter, prospective, National Surgical Quality Improvement Program (NSQIP) datasets (2007/2008) were used. Multivariable logistic regression was performed.
  
  
  RESULTS
  Eighty-three of 20,778 (0.4%) patients developed PRF. Comparing patients who developed PRF to those who did not, 30-day mortality was seen in 13 of 83 versus 11 of 20,695 patients (p < .0001); and mean length of stay (LOS) was 9.1 (±9.5) days versus 1.1 (±1.6) days (p < .0001). Multivariable analysis demonstrated preoperative pneumonia, dependent functional status, dyspnea, dialysis dependence, hypertension, advanced age, and combined thyroid and parathyroid surgery as risk factors for PRF.
  
  
  CONCLUSIONS
  PRF after thyroid and parathyroid surgeries is uncommon, but associated with significantly increased 30-day morbidity and mortality.
authors.affiliation: Department of Surgery, Creighton University, Omaha, Nebraska, USA.
authors.forename: Prateek K
authors.initials: PK
authors.lastname: Gupta
authors.forename: Himani
authors.initials: H
authors.lastname: Gupta
authors.forename: Bala
authors.initials: B
authors.lastname: Natarajan
authors.forename: Shreya
authors.initials: S
authors.lastname: Shetty
authors.forename: Russell B
authors.initials: RB
authors.lastname: Smith
authors.forename: Robert
authors.initials: R
authors.lastname: Lindau
authors.forename: Xiang
authors.initials: X
authors.lastname: Fang
authors.forename: William M
authors.initials: WM
authors.lastname: Lydiatt
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010279:Parathyroid Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000009:adverse effects*; D058996:Quality Improvement; D012131:Respiratory Insufficiency / Q000453:epidemiology*; D012307:Risk Factors; D013959:Thyroid Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D014481:United States