Introduction: Numbers of thyroidectomies and awareness of postoperative quality measures have both increased. Potential sex-specific variations in clinical outcomes of patients undergoing thyroidectomy are controversial. Objective: The aim of this study was to investigate sex-specific differences in outcomes following thyroidectomy. Methods: This is a population-based cohort study of all adult patients undergoing either hemi- or total thyroidectomy in Switzerland from 2011 to 2015. The primary outcome was all-cause 30-day readmission rate. The main secondary outcomes were intensive care unit (ICU) admission, surgical re-intervention, in-hospital mortality, length of hospital stay (LOS), postoperative calcium disorder, vocal cord paresis, and hematoma. Results: Of 16,776 patients undergoing thyroidectomy, the majority of patients undergoing thyroidectomy were female (79%), with a median age of 52 (IQR 42–64) years. Within 30 days after the surgery, male patients had significantly higher rates of hospital readmission (adjusted risk ratio [RR] 1.38; 95% confidence interval [95% CI] 1.11–1.72, p = 0.008) and higher risks for postoperative ICU admission (RR 1.25; 95% CI, 1.09–1.44, p = 0.003) than female patients. There were no significant differences among sexes in the LOS, rates of surgical re-interventions, or in-hospital mortality. While postoperative calcium disorders due to hypoparathyroidism were less prevalent among male patients (RR 0.63; 95% CI, 0.54–0.72, p #x3c; 0.001), a 2-fold higher incidence rate of postoperative hematoma was observed (RR 1.93, 95% CI, 1.51–2.46, p #x3c; 0.001). Conclusions: Male patients undergoing thyroidectomy have higher 30-day hospital readmission and ICU admission rates. Following surgery, male patients revealed higher rates of neck hematoma, while hypocalcemia was more frequent among female patients.
Eur Thyroid J

中文翻译：

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甲状腺切除术后结果的性别特异性差异：基于人群的队列研究


简介：甲状腺切除术的数量和术后质量措施的意识均有所增加。接受甲状腺切除术的患者临床结果的潜在性别特异性差异存在争议。目的：本研究的目的是调查甲状腺切除术后结果的性别差异。方法：这是一项基于人群的队列研究，研究对象为 2011 年至 2015 年在瑞士接受甲状腺半切除术或全甲状腺切除术的所有成年患者。主要结果是全因 30 天再入院率。主要的次要结局是入住重症监护病房（ICU）、再次手术干预、院内死亡率、住院时间（LOS）、术后钙紊乱、声带麻痹和血肿。结果：在 16,776 名接受甲状腺切除术的患者中，大多数接受甲状腺切除术的患者为女性（79%），中位年龄为 52 岁（IQR 42-64）岁。术后 30 天内，男性患者的再入院率显着较高（调整后风险比 [RR] 1.38；95% 置信区间 [95% CI] 1.11–1.72， p = 0.008）且术后入住 ICU 的风险较高（ RR 1.25；95% CI，1.09–1.44， p = 0.003）高于女性患者。不同性别的 LOS、再次手术干预率或院内死亡率没有显着差异。虽然男性患者中甲状旁腺功能减退导致的术后钙紊乱较少见（RR 0.63；95% CI，0.54-0.72， p #x3c；0.001），但术后血肿发生率却高出 2 倍（RR 1.93，95%） CI，1.51–2.46， p #x3c； 结论：接受甲状腺切除术的男性患者 30 天再入院率和 ICU 入住率较高。手术后，男性患者颈部血肿的发生率较高，而女性患者中低钙血症的发生率更高。
 欧洲甲状腺杂志