title: Can we consider immediate complications after thyroidectomy as a quality metric of operation?
abstract: Permanent recurrent laryngeal nerve palsy and hypoparathyroidism are 2 major complications after thyroid operation. Assuming that the rate of immediate complications can predict the permanent complication rate, some authors consider these complications as a valid metric for assessing the performance of individual surgeons. This study aimed to determine the correlation between rates of immediate and permanent complications after thyroidectomy at the surgeon level.
  
  
  
  We conducted a prospective, cross-sectional study in 5 academic hospitals between April 2008 and December 2009. The correlation between the rates of immediate and permanent complications for each of the 22 participating surgeons was calculated using the Pearson correlation test (r).
  
  
  
  The study period included 3,605 patients. There was a fairly good correlation between rates of immediate and permanent recurrent laryngeal nerve palsy (r = 0.70, P = .004), but no correlation was found for immediate and permanent hypoparathyroidism (r = 0.18, P = .427).
  
  
  
  The immediate hypoparathyroidism rate does not reflect the permanent hypoparathyroidism rate. Consequently, immediate hypoparathyroidism should not be used to assess the quality of thyroidectomy or to monitor the performance of surgeons.
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Chirurgie Générale et Endocrinienne, Pierre Bénite, Université Claude Bernard Lyon 1, Health Services and Performance Research Lab, Lyon, France; Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France. Electronic address: jean-christophe.lifante@chu-lyon.fr.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Lifante
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Payet
authors.affiliation: Department of Endocrine Surgery, Jean Bernard Hospital, Poitiers, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Ménégaux
authors.affiliation: Department of Endocrine Surgery, Jean Bernard Hospital, Poitiers, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sebag
authors.affiliation: Poitiers University, Jean Bernard Hospital, Poitiers, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Kraimps
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Chirurgie Générale et Endocrinienne, Pierre Bénite, Université Claude Bernard Lyon 1, Health Services and Performance Research Lab, Lyon, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Peix
authors.affiliation: CHRU de Lille, Chirurgie Générale et Endocrinienne, Lille, France; Université Lille nord de France, INSERM, Lille, France.
authors.forename: François
authors.initials: F
authors.lastname: Pattou
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France; Assistance Publique-Hôpitaux de Paris, Hôpital la Pitié-Salpêtrière, Service de Chirurgie Générale, Viscérale et Endocrinienne, Paris, Assistance Publique-Hôpitaux de Marseille, CHU la Conception, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Colin
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France; Assistance Publique-Hôpitaux de Paris, Hôpital la Pitié-Salpêtrière, Service de Chirurgie Générale, Viscérale et Endocrinienne, Paris, Assistance Publique-Hôpitaux de Marseille, CHU la Conception, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Duclos
mesh_terms: D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D019538:Health Care Surveys; D061847:Hospitals, High-Volume; D006801:Humans; D007011:Hypoparathyroidism / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D066231:Surgeons / Q000706:statistics & numerical data; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D014826:Vocal Cord Paralysis / Q000453:epidemiology* / Q000209:etiology