Safety of Outpatient Thyroid and Parathyroid Surgery: A Propensity Score–Matched Study

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Abstract

Objective

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.

Study Design

Retrospective observational cohort, 2008 to 2013.

Setting

Kaiser Permanente Northern California and Kaiser Permanente Southern California.

Subjects and Methods

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.

Results

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.

Conclusion

Discharge within 8 hours after completion of thyroid and parathyroid surgery is as safe as inpatient surgery.

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