title: [Complications after thyroid gland operations in Germany : A routine data analysis of 66,902 AOK patients].
abstract: BACKGROUND
  Routine data from hospitals in the public healthcare system allow the analysis of large patient datasets without generating additional documentation efforts for hospitals. This study reports the frequencies of postoperative complications after thyroid surgery based on routine nationwide data. Moreover, volume-outcome relationships were investigated.
  
  
  METHODS
  Nationwide routine data from insured patients of the Local Health Insurance Fund (AOK) who underwent thyroid surgery between 2008 and 2010 were analyzed. Complications were determined based on indicators for permanent vocal cord palsy, re-bleeding with re-operations and wound infections with specific treatment. The effect of hospital volumes (volume quintiles) on the indicators was determined by multivariate logistic regression.
  
  
  RESULTS
  A total of 66,902 thyroid gland operations were identified. The overall frequency of permanent vocal cord palsy was 1.5 %, re-bleeding 1.8 % and wound infections 0.4 %. In the four lowest case volume categories the risk of permanent vocal cord palsy was significantly higher compared to the highest case volume hospitals (odds ratio 1.5, 1.7, 1.7 and 2.2, respectively).
  
  
  CONCLUSIONS
  This study represents the reality of healthcare for thyroid surgery in Germany. Additionally, it was determined that the risk for permanent vocal cord palsy after thyroid gland operations decreased with increasing case volumes of hospitals.
authors: Wissenschaftliches Institut der AOK, Rosenthaler Str. 31, 10178, Berlin, Deutschland. Matthias.Maneck@wido.bv.aok.de.
authors: M
authors: M
authors: Maneck
authors: Klinik für Endokrine Chirurgie, Helios Klinikum Wuppertal, Wuppertal, Deutschland.
authors: C
authors: C
authors: Dotzenrath
authors: Universitätsklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland.
authors: H
authors: H
authors: Dralle
authors: AOK-Bundesverband, Berlin, Deutschland.
authors: C
authors: C
authors: Fahlenbrach
authors: Klinik für Endokrinologie und Nephrologie, Universität Leipzig, Leipzig, Deutschland.
authors: R
authors: R
authors: Paschke
authors: Zentrum für Endokrine Chirurgie, DRK Kliniken Berlin/Westend, Berlin, Deutschland.
authors: T
authors: T
authors: Steinmüller
authors: Medizinischer Dienst der Krankenversicherung Berlin-Brandenburg, Berlin, Deutschland.
authors: E
authors: E
authors: Tusch
authors: Wissenschaftliches Institut der AOK, Rosenthaler Str. 31, 10178, Berlin, Deutschland.
authors: E
authors: E
authors: Jeschke
authors: Wissenschaftliches Institut der AOK, Rosenthaler Str. 31, 10178, Berlin, Deutschland.
authors: C
authors: C
authors: Günster
mesh_terms: D000328:Adult; D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D005858:Germany; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data*; D061846:Hospitals, Low-Volume / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D013959:Thyroid Diseases / Q000453:epidemiology* / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects* / Q000706:statistics & numerical data*; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery
keywords: Benign goiter; Complications; Routine data; Thyroid surgery; Volume outcome