title: Risk factors for neck hematoma after thyroid or parathyroid surgery: ten-year analysis of the nationwide inpatient sample database.
abstract: BACKGROUND
  Postoperative neck hematoma is a well-known complication of thyroid and parathyroid surgery. Better understanding of risk factors for hematoma formation will help define high-risk populations.
  
  
  OBJECTIVE
  To examine possible risk factors for neck hematoma after thyroid or parathyroid surgery.
  
  
  METHODS
  Retrospective analysis of hospital discharge data from the Nationwide Inpatient Sample database.
  
  
  METHODS
  Using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis and procedures codes, we identified adults who underwent thyroid or parathyroid surgery and in whom neck hematoma subsequently developed. Information about demographic, clinical, and hospital characteristics was collected. Multivariate regression analyses were used to predict independent risk factors for neck hematoma.
  
  
  RESULTS
  We identified 147,344 thyroid and parathyroid operations performed nationwide between 2000 and 2009. Overall incidence of postoperative neck hematoma was 1.5% (n = 2210). In multivariate analysis, age 65 years and older (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.4-2.1), male sex (OR = 1.3, 95% CI = 1.2-1.4), African-American race (OR = 1.5, 95% CI = 1.2-1.7), being from the South (OR = 1.3, 95% CI = 1-1.4), comorbidity score of 3 or more (OR = 2, 95% CI = 1.6-2.6), history of alcohol abuse (OR = 2.7, 95% CI = 1.6-2.5), Graves disease (OR = 3, 95% CI = 2.1-4.1), and substernal thyroidectomy (OR = 3.3, 95% CI = 2.8-3.9) were associated with a higher risk of neck hematoma.
  
  
  CONCLUSIONS
  We identified demographic and clinical factors associated with increased risk of neck hematoma after thyroid or parathyroid surgery.
authors: Resident at the Fontana Medical Center in CA. ahmed.n.dehal@kp.org.
authors: Ahmed
authors: A
authors: Dehal
authors: Resident at Shands Hospital at the University of Florida in Gainesville. aabbas983@gmail.com.
authors: Ali
authors: A
authors: Abbas
authors: General Surgeon at the Arrowhead Regional Medical Center in Colton, CA. hussainf@armc.sbcounty.gov.
authors: Farabi
authors: F
authors: Hussain
authors: General Surgeon at the Fontana Medical Center in CA. samir.d.johna@kp.org.
authors: Samir
authors: S
authors: Johna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009333:Neck; D016105:Parathyroidectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013965:Thyroidectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult