title: Mortality after thyroid surgery, insignificant or still an issue?
abstract: BACKGROUND
  Thyroidectomy is considered to be a safe procedure. Although very uncommon, death may occur after thyroid resection. The aim of this study was to investigate the prevalence and causes of death after thyroidectomy and the associated risk factors in the modern era of thyroid surgery.
  
  
  METHODS
  A structured questionnaire was sent to all endocrine surgery units in Spain to report all deaths that occurred after thyroidectomy in recent years.
  
  
  RESULTS
  Twenty-six surgical units, encompassing 30.495 thyroidectomies, returned the questionnaire. A total of 20 deaths (0.065%) were recorded: 12 women (60%) and 8 men (40%) with a median age of 65 years (range 32-86). Half of the patients had a retrosternal goiter with a median weight of 210 g. The median operative time was 185 min. Histological diagnoses were benign goiter (35%) or thyroid carcinoma (65%): differentiated (30%), medullary (20%), poorly differentiated/anaplastic (10%), and colorectal cancer metastasis (5%). Causes of death were cervical hematoma (30%), respiratory distress/pneumonia due to prolonged endotracheal intubation (25%), tracheal injury (15%), heart failure (15%), sepsis (wound infection/esophageal perforation) (10%) and mycotic aneurysm (5%). The median time from surgery to death was 14 days (range 1-85).
  
  
  CONCLUSIONS
  Death after thyroidectomy is very uncommon, and most often results from a combination of advanced age, giant goiters, and upper airway complications.
authors.affiliation: Neck and Breast Surgery Unit, Department of Surgery, Hospital Fundación Jiménez Díaz, Avda Reyes Católicos, 2, 28040, Madrid, Spain, jgomezramirez@hotmail.com.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Gómez-Ramírez
authors.forename: Antonio
authors.initials: A
authors.lastname: Sitges-Serra
authors.forename: Pablo
authors.initials: P
authors.lastname: Moreno-Llorente
authors.forename: Antonio Ríos
authors.initials: AR
authors.lastname: Zambudio
authors.forename: Joaquín
authors.initials: J
authors.lastname: Ortega-Serrano
authors.forename: María Teresa Gutiérrez
authors.initials: MT
authors.lastname: Rodríguez
authors.forename: Jesús Villar
authors.initials: JV
authors.lastname: del Moral
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006042:Goiter / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000401:mortality / Q000601:surgery*; D013965:Thyroidectomy / Q000401:mortality*