735 Day Case Hemithryroidectomy Audit

Abstract

Abstract Aim Post-operative haematomas are a serious complication of thyroid surgery, causing potential airway compromise and fatality. Over time, hemithyroidectomy operations are increasingly being carried out as day case procedures to encourage enhanced recovery programmes post-operatively as well as reduce bed pressures on an overwhelmed National Health Service due to the COVID-19 pandemic. Method Hemithyroidectomy procedures carried out from 2018–2021 were analysed in 3 separate audit cycles. Outcome measures included total length of stay (LOS) in hospital, average time of operation note documentation, admission reason and any complication during or after the procedure, including complications within a 10-day period of the procedure. Results The percentage of same-day discharges increased reliably from audit cycle 1 (2018) to audit cycle 2 (2019) to audit cycle 3 (2021); it was found that same-day discharges increased from 48% to 64% to 70%, respectively. It was further found that if operation notes (assumed to act as a proxy for approximate time-out for procedure) were documented towards the end of the working day i.e., 5pm in most units, it was more likely for patients to be admitted overnight. There was one patient from the period of 2018–2021 that was deemed to have had a serious post-operative event. Conclusions There was a reliably increase in same-day discharges for each successive audit cycle. There is a limited requirement for patients undergoing hemithyroidectomy procedures to have a surgical drain placed. Hemithyroidectomy operations can be carried out safely as day case procedures based on the observations of this audit.