Postoperative Systolic Blood Pressure as a risk factor for haematoma following thyroid surgery.

Abstract

To examine potential factors that may predict development of postoperative haematoma following thyroid surgery, with particular attention to postoperative systolic blood pressure. Retrospective, observational case-control study of patients undergoing thyroid surgery. Secondary General Hospital. Patients attending Counties Manukau District Health Board (CMDHB) between 2002 and 2012. Post-operative Haematoma formation that required re-exploration of the wound. The overall rate of postoperative haematoma was 2.57% (16/621). Three patients bled immediately (i.e. after wound closure but while still on the operating table); 10 patients (1.6%) bled in the early postoperative period; and three others bled 24h or more after surgery. The principal independent risk factor for postoperative haemorrhage that remained after multivariable regression was postoperative systolic blood pressure level. There was a 39% increase in risk of bleeding for every 10 points rise of highest blood pressure recordings in our patient population (OR 1.39; 95% CI=1.09-1.8). This study identifies postoperative hypertension as significantly related to development of early postoperative haematoma. Cause for late post-thyroidectomy bleeding remains speculative.