title: Postoperative Systolic Blood Pressure as a risk factor for haematoma following thyroid surgery.
abstract: OBJECTIVE
  To examine potential factors that may predict development of postoperative haematoma following thyroid surgery, with particular attention to postoperative systolic blood pressure.
  
  
  METHODS
  Retrospective, observational case-control study of patients undergoing thyroid surgery.
  
  
  METHODS
  Secondary General Hospital.
  
  
  METHODS
  Patients attending Counties Manukau District Health Board (CMDHB) between 2002 and 2012.
  
  
  METHODS
  Post-operative Haematoma formation that required re-exploration of the wound.
  
  
  RESULTS
  The overall rate of postoperative haematoma was 2.57% (16/621). Three patients bled immediately (i.e. after wound closure but while still on the operating table); 10 patients (1.6%) bled in the early postoperative period; and three others bled 24 h or more after surgery. The principal independent risk factor for postoperative haemorrhage that remained after multivariable regression was postoperative systolic blood pressure level. There was a 39% increase in risk of bleeding for every 10 points rise of highest blood pressure recordings in our patient population (OR 1.39; 95% CI = 1.09-1.8).
  
  
  CONCLUSIONS
  This study identifies postoperative hypertension as significantly related to development of early postoperative haematoma. Cause for late post-thyroidectomy bleeding remains speculative.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Counties-Manukau Health, Manukau City, Auckland, New Zealand.|Department of Surgery, University of Auckland, Auckland, New Zealand.
authors.forename: Randall P
authors.initials: RP
authors.lastname: Morton
authors.affiliation: Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.|Ko Awatea, Counties Manukau Health, Auckland, New Zealand.
authors.forename: Alain C
authors.initials: AC
authors.lastname: Vandal
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013961:Thyroid Gland / Q000601:surgery; D013965:Thyroidectomy