title: Safety of Outpatient Thyroid and Parathyroid Surgery: A Propensity Score-Matched Study.
abstract: To test our hypothesis that general and thyroid surgery-specific complications, mortality, and postdischarge utilization for patients undergoing outpatient and inpatient thyroid and parathyroid surgery would not differ when outpatient status was defined as discharge within 8 hours of surgery completion.
  
  
  
  Retrospective observational cohort, 2008 to 2013.
  
  
  
  Kaiser Permanente Northern California and Kaiser Permanente Southern California.
  
  
  
  We used a robust set of variables and propensity score methods to match 2362 patients undergoing hemithyroidectomy, total thyroidectomy, or parathyroidectomy surgery as outpatients to 2362 patients undergoing the same procedures as inpatients. Outcomes assessed were 30-day rates of complications, emergency department visits, all-cause hospital readmissions, and mortality.
  
  
  
  After matching, no statistically significant differences between inpatients and outpatients were found for complication rates or postdischarge utilization. After matching, there was no statistically significant difference between inpatients and outpatients in hematoma rates, which were 0.55% in both groups. In the matched-pair groups, 2 deaths occurred among inpatients (0.09%) and none occurred among outpatients (0.00%), a difference that was not statistically significant.
  
  
  
  Discharge within 8 hours after completion of thyroid and parathyroid surgery is as safe as inpatient surgery.
authors.affiliation: The Permanente Medical Group, Santa Rosa, California, USA charles.meltzer@kp.org.
authors.forename: Charles
authors.initials: C
authors.lastname: Meltzer
authors.affiliation: Southern California Permanente Medical Group, Anaheim, California, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Klau
authors.affiliation: The Permanente Medical Group, Oakland, California, USA.
authors.forename: Deepak
authors.initials: D
authors.lastname: Gurushanthaiah
authors.affiliation: Health Information Technology and Transformation Analytics, Kaiser Permanente, Oakland, California, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Tsai
authors.affiliation: Health Information Technology and Transformation Analytics, Kaiser Permanente, Oakland, California, USA.
authors.forename: Di
authors.initials: D
authors.lastname: Meng
authors.affiliation: The Permanente Federation, Oakland, California, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Radler
authors.affiliation: The Permanente Federation, Oakland, California, USA.
authors.forename: Alvina
authors.initials: A
authors.lastname: Sundang
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010279:Parathyroid Diseases / Q000601:surgery*; D016105:Parathyroidectomy; D061214:Patient Safety; D011183:Postoperative Complications / Q000401:mortality; D057216:Propensity Score; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome
keywords: outpatient surgery; parathyroidectomy; patient safety; surgical outcomes; thyroidectomy