Endocrine Abstracts

Background: Incidence of thyroidectomies and awareness to postoperative quality measures have both increased in the last decade. Gender-specific indications and variations in clinical outcomes of patients undergoing thyroidectomy in Switzerland are of interest.

Methods: We cross-sectionally compared administrative nationwide patient-level data for length of hospital stay (LOS), intensive care unit (ICU) admission, 30-day readmissions rates, and other quality measures among hospitalized female and male patients from January 2011 through December 2015. Multivariate regression models were used to determine gender-specific variations.

Results: A total of 17,410 patients were included whereof 8,629 underwent a unilateral thyroidectomy and 8,721 a total thyroidectomy. 13,732 (78.9%) were female and the median age was 52 (IQR 41–63) and 54 (IQR 44–65) for females and males, respectively. The overall mean LOS was lower in female compared to male patients (3.3 [SD 2.8] vs 3.6 [SD 4.0] days, P<0.001). Male patients had a higher risk for postoperative ICU admission compared with female patients (4.8% vs 7.9%; OR, 1.59 [95%CI, 1.38–1.84], P<0.001). 30-day overall readmission rate was increased by about 40% in male patients compared to females (5.5% vs 9.3%; OR, 1.42 [95%CI, 1.23–1.63], P<0.001). In contrast, less postoperative hypocalcemia were documented in male patients (6.0% vs 8.5%; OR, 0.66 [95%CI, 0.57–0.76], P<0.001). The rate of recurrent laryngeal nerve palsy was similar between females and males (2.1% vs 2.4%; OR, 1.05 [95%CI, 0.84–1.33], P=0.67).

Conclusions: In Switzerland, the rate of thyroidectomies is more than four times higher in females than in males. Female patients undergoing unilateral- or total thyroidectomy had more favourable clinical outcomes compared with male patients. Importantly, these findings are not explained by the common complications of thyroidectomy (i.e. hypoparathyroidism and laryngeal nerve palsy). The underlying reasons remain to be elucidated.