title: Risk factors for post-thyroidectomy haematoma.
abstract: BACKGROUND
  There has been increasing emphasis on performing 'same-day' or 'out-patient' thyroidectomy to reduce associated costs. However, acceptance has been limited by the risk of potentially life-threatening post-operative bleeding. This study aimed to review current rates of post-operative bleeding in a metropolitan teaching hospital and identify risk factors.
  
  
  METHODS
  Medical records of patients undergoing thyroidectomy between January 2007 and March 2012 were reviewed retrospectively. Pre-operative, operative and pathological data, and post-operative complication data, were examined.
  
  
  RESULTS
  The study comprised 205 thyroidectomy cases. Mean age was 51.6 years (standard deviation = 14.74), with 80 per cent females. Unilateral thyroidectomy was performed in 81 cases (39.5 per cent) and total thyroidectomy was performed in 74 cases (36.1 per cent; 5.3 per cent with concomitant lymph node dissection). Nine patients (4.4 per cent) suffered post-operative bleeding, of which six required re-operation. Analysis showed that post-operative systolic blood pressure of 180 mmHg or greater was associated with post-operative bleeding (p = 0.003, chi-square test).
  
  
  CONCLUSIONS
  Rates of significant post-operative bleeding are consistent with recent literature. Post-operative hypertension, diabetes and high post-operative drain output were identified as independent risk factors on multivariate analysis; when identified, these may be caveats to same-day discharge of thyroidectomy patients.
authors.affiliation: Department of Surgery,Western Health,Footscray,Australia.
authors.forename: M
authors.initials: M
authors.lastname: Perera
authors.affiliation: Department of Surgery,Western Health,Footscray,Australia.
authors.forename: L
authors.initials: L
authors.lastname: Anabell
authors.affiliation: Department of Surgery,Western Health,Footscray,Australia.
authors.forename: D
authors.initials: D
authors.lastname: Page
authors.affiliation: Department of Surgery,Western Health,Footscray,Australia.
authors.forename: T
authors.initials: T
authors.lastname: Harding
authors.affiliation: Department of Surgery,Western Health,Footscray,Australia.
authors.forename: N
authors.initials: N
authors.lastname: Gnaneswaran
authors.affiliation: Department of Surgery,Western Health,Footscray,Australia.
authors.forename: S
authors.initials: S
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D001794:Blood Pressure; D005260:Female; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011184:Postoperative Period; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013965:Thyroidectomy / Q000009:adverse effects* / Q000706:statistics & numerical data
keywords: Thyroidectomy; Postoperative Complications; Postoperative Procedures; Adverse Effects; Hematoma; Surgery