PMID- 24008557
OWN - NLM
STAT- MEDLINE
DCOM- 20140122
LR  - 20131122
IS  - 2168-619X (Electronic)
IS  - 2168-6181 (Linking)
VI  - 139
IP  - 11
DP  - 2013 Nov
TI  - Causes of emergency department visits following thyroid and parathyroid surgery.
PG  - 1175-80
LID - 10.1001/jamaoto.2013.4505 [doi]
AB  - IMPORTANCE: With reimbursement being increasingly tied to outcome measures, 
      minimizing unexpected health care needs in the postoperative period is essential. 
      This article describes reasons for emergency department (ED) evaluation, rates of 
      readmission to the hospital, and significant risk factors for readmission during 
      the postoperative period. OBJECTIVE: To describe the subset of patients requiring 
      ED evaluation within 30 days of thyroidectomy or parathyroidectomy and their 
      associated risk factors. DESIGN, SETTING, AND PATIENTS: Retrospective chart 
      review in a tertiary care center of adult patients who underwent thyroidectomy or 
      parathyroidectomy between January 1, 2009 and October 7, 2010. Patients were 
      identified from an institutional review board-approved database. Postoperative 
      patients who visited the emergency department (ED) within the first 30 days 
      following surgery were selected and compared with the postoperative patients who 
      did not visit the ED. EXPOSURES: Thyroidectomy or parathyroidectomy. MAIN 
      OUTCOMES AND MEASURES: Statistical analysis evaluated the association of 
      demographic and clinical characteristics between the patients who required ER 
      evaluation and those who did not. Clinical characteristics evaluated included 
      type of surgery, medical comorbidities, and proton pump inhibitor (PPI) usage. 
      Multiple logistic regression predicted the odds of an ED visit based on presence 
      of diabetes, gastroesophageal reflux disease (GERD), or PPI use. RESULTS: Of the 
      570 patients identified, 64 patients required a visit to the ER a total of 75 
      times for issues including paresthesias (n = 28), wound complications (n = 8), 
      and weakness (n = 6). Fifteen hospital admissions occurred for treatment of a 
      variety of postoperative complications. A significant association was found 
      between the presence of diabetes (P = .03), GERD (P = .04), and the current use 
      of PPIs (P = .03). When controlling for diabetes and GERD, we found that patients 
      taking PPIs were 1.81 times more likely to visit the ED than patients not taking 
      PPIs (P = .04). CONCLUSIONS AND RELEVANCE: Patients taking PPIs are 1.81 times 
      more likely to require ED evaluation than those who are not taking PPIs.
FAU - Young, William G
AU  - Young WG
AD  - Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, 
      Detroit, Michigan.
FAU - Succar, Eric
AU  - Succar E
FAU - Hsu, Linda
AU  - Hsu L
FAU - Talpos, Gary
AU  - Talpos G
FAU - Ghanem, Tamer A
AU  - Ghanem TA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JAMA Otolaryngol Head Neck Surg
JT  - JAMA otolaryngology-- head & neck surgery
JID - 101589542
SB  - IM
MH  - Comorbidity
MH  - Emergency Service, Hospital/*statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Michigan/epidemiology
MH  - Middle Aged
MH  - Parathyroid Diseases/epidemiology/*surgery
MH  - *Parathyroidectomy
MH  - Postoperative Care/statistics & numerical data
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tertiary Care Centers/*statistics & numerical data
MH  - Thyroid Diseases/epidemiology/*surgery
MH  - *Thyroidectomy
EDAT- 2013/09/07 06:00
MHDA- 2014/01/23 06:00
CRDT- 2013/09/07 06:00
PHST- 2013/09/07 06:00 [entrez]
PHST- 2013/09/07 06:00 [pubmed]
PHST- 2014/01/23 06:00 [medline]
AID - 1735286 [pii]
AID - 10.1001/jamaoto.2013.4505 [doi]
PST - ppublish
SO  - JAMA Otolaryngol Head Neck Surg. 2013 Nov;139(11):1175-80. doi: 
      10.1001/jamaoto.2013.4505.