Risk Factors for Prolonged Hospital Stay and 90-Day Readmission After Thyroidectomy in the Pediatric Population: A Nationwide Readmissions Database 2016-2020 Analysis

IF 4.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2026-09-01 Epub Date: 2026-04-09 DOI:10.1016/j.eprac.2026.04.001

Jyun-Ming Huang MD, Chen-Sheng Huang MD

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引用次数: 0

Abstract

Objectives

Thyroidectomy in children, though uncommon, is indicated for malignancies, benign goiters, and hyperthyroidism. While generally safe, concerns remain regarding postoperative complications, prolonged hospitalization, and readmission. However, large-scale data on risk factors for these outcomes in pediatric patients are limited. This study aimed to identify factors associated with prolonged hospital stay and 90-day readmission using a nationally representative database.

Methods

Data from the Nationwide Readmissions Database from 2016 to 2020 were retrospectively analyzed. Children 1-19 year old who underwent thyroidectomy were included in this study. Prolonged length of stay (LOS) was defined as LOS at or above the 75th percentile. Multivariable logistic regression using backward selection identified factors independently associated with prolonged LOS and 90-day readmission.

Results

A total of 871 pediatric thyroidectomy cases were identified, representing 2081 weighted admissions. The mean age of the patients was 14.6 years, and 75% were female. Total thyroidectomy (adjusted odds ratio [aOR] = 2.61), emergent surgery (aOR = 2.58), diabetes mellitus (aOR = 2.55), postoperative hypocalcemia (aOR = 3.05), and respiratory failure (aOR = 10.37) were associated with prolonged LOS. Factors associated with increased risk of 90-day readmission were male sex (aOR = 2.80), total thyroidectomy (aOR = 2.65), autoimmune disease (aOR = 3.28), postoperative hypocalcemia (aOR = 1.90), and postprocedural pain (aOR = 3.33).

Conclusions

This study identified key risk factors for prolonged hospitalization and readmission after thyroidectomy in children. These findings may support tailored perioperative strategies to improve outcomes and optimize health care resource utilization in this population.

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儿童甲状腺切除术后延长住院时间和90天再入院的危险因素：2016-2020年全国再入院数据库分析

目的：儿童甲状腺切除术虽然不常见，但适用于恶性肿瘤、良性甲状腺肿大和甲状腺功能亢进。虽然总体上是安全的，但术后并发症、长期住院和再入院的问题仍然存在。然而，关于儿童患者这些结局的危险因素的大规模数据是有限的。本研究旨在利用全国代表性数据库确定与延长住院时间和90天再入院相关的因素。方法：回顾性分析2016 - 2020年全国再入院数据库（NRD）的数据。本研究包括1-19岁接受甲状腺切除术的儿童。延长停留时间（LOS）定义为停留时间等于或高于第75个百分位数。使用反向选择的多变量逻辑回归确定了与LOS延长和90天再入院独立相关的因素。结果：共有871例儿童甲状腺切除术被确定，代表2081加权入院。患者平均年龄14.6岁，女性占75%。全甲状腺切除术（调整优势比[aOR] = 2.61）、紧急手术（aOR = 2.58）、糖尿病（aOR = 2.55）、术后低钙（aOR = 3.05）和呼吸衰竭（aOR = 10.37）与延长的LOS相关。与90天再入院风险增加相关的因素为男性（aOR = 2.80）、全甲状腺切除术（aOR = 2.65）、自身免疫性疾病（aOR = 3.28）、术后低钙血症（aOR = 1.90）和术后疼痛（aOR = 3.33）。结论：本研究确定了儿童甲状腺切除术后长期住院和再入院的关键危险因素。这些发现可能支持定制围手术期策略，以改善预后并优化该人群的医疗资源利用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.