TÜRKİYE’DE YAPILAN TİROİDEKTOMİ İŞLEMLERİNE İLİŞKİN KESİTSEL BİR DEĞERLENDİRME

Amaç: Bu çalışmanın amacı, Türkiye'de tiroidektomi yapılan hasta popülasyonunda tiroidektomi işlem türleri ve tanıları, cinsiyet, yaş, klinik özellikler ve hastanede kalış sürelerini belirlemekti. Ayrıca demografik ve klinik özelliklerin hastanede kalış süresine etkisinin belirlenmesi amaçlandı. Yöntem: Bu araştırma retrospektif kesitsel bir çalışmadır. Çalışmada, Türkiye'de bir yıl içinde tiroidektomi işlemi uygulanan hastaların demografik ve klinik verileri incelendi. Araştırma verileri 2016 yılında Sağlık Bakanlığı'na bağlı hastanelerde tiroidektomi operasyonu geçiren 25167 hastanın verilerini içerdi. Tiroidektomi vakalarına ilişkin tanı ve işlemlerin gruplandırılmasında ICD-10-AM kullanıldı. Verilerin analizinde tanımlayıcı istatistikler, Bağımsız Örneklemler T-testi, Mann-Whitney U-Testi ve Kruskal-Wallis testi kullanıldı. Bulgular: Hasta grubunda en sık yapılan cerrahi işlem total tiroidektomiydi. Çalışma grubunda yaş ortalaması 49.62±12.917 yıl olup, hastaların çoğunluğu (%81) kadındı. Ortalama hastanede kalış süresi 4.87±3.308 gündü. Sonuç: Tiroidektomi operasyonu geçiren erkek cinsiyette, 50 yaş ve üzerinde, neoplazm tanısı olanlarda, enfeksiyonlularda, hipertansif hastalığı olanlarda, kalp hastalığı olanlarda, tiroidektomi dışında başka cerrahi işlemler geçirenlerde, komplikasyon gelişenlerde diğer hasta gruplarına göre hastanede kalış süresinin daha uzun olduğu sonucuna varıldı.

Anahtar Kelimeler:

Hastanede Kalış Süresi, Hasta Özellikleri, Tiroid Hastalığı, Tiroidektomi, Türkiye

A CROSS-SECTIONAL ASSESSMENT ON THE THYROIDECTOMY PROCEDURES IN TURKEY

Objective: The aim of this study is to determine the types of thyroidectomy procedures and diagnosis, gender, age, clinical characteristics, and duration of stay in hospital in the patient population who underwent thyroidectomy in Turkey. In addition, it was aimed to determine the effect of demographic and clinical characteristics on the duration of hospital stay. Method: This research is a retrospective cross-sectional study. In the study, the demographic and clinical data of the patients who underwent thyroidectomy procedures during one year in Turkey were examined. Research data involves the data of the 25167 patients who underwent thyroidectomy procedures in the hospitals of the Ministry of Health in 2016. ICD-10-AM was used in grouping the diagnosis and procedures related to thyroidectomy cases. Descriptive statistics, Independent Samples T-test, Mann-Whitney U-Test, and Kruskal-Wallis test were used in the analysis of the data. Results: The most common surgical procedure performed in the patient group is total thyroidectomy. In the study group, the mean age was 49.62±12.917 years and the majority (81%) of patients were females. The average duration of hospital stay was 4.87±3.308 days. Conclusion: It was concluded that the duration of hospital stay was longer in patients who underwent a thyroidectomy procedure, in the male sex, those aged 50 years or over, those with a diagnosis of neoplasm, those with infection, hypertensive disease, and heart disease, those who underwent other surgical procedures in addition to thyroidectomy, and those who developed complications compared to other patient groups.

Keywords:

Duration of Hospital Stay, Patient Characteristics, Thyroid Disease, Thyroidectomy, Turkey,

PDF

___

Padur A, Kumar N, Guru A, et al. Safety and effectiveness of total thyroidectomy and its comparison with subtotal thyroidectomy and other thyroid surgeries: a systematic review. J Thyroid Res. 2016;2016(7594615):1-6.
Türkiye Endokrinoloji ve Metabolizma Derneği. Tiroid Hastalıkları Tanı ve Tedavi Kılavuzu 2019. Ankara; 2020.
World Health Organization. Assessment of İodine Deficiency Disorders and Monitoring Their Elimination Third Edition A Guide for Programme Managers. Third. Geneva; 2007.
Erdoğan G, Erdoğan MF, Emral R, Baştemir M, Sav H, Haznedaroğlu D, et al. Iodine status and goiter prevalence in Turkey before mandatory iodization. J Endocrinol Invest. 2002;25(3):224-228.
Erdoǧan MF, Aǧbaht K, Altunsu T, et al. Current iodine status in Turkey. J Endocrinol Invest. 2009;32(7):617-622. Kinberg EC WEBA. Thyroidectomy [Internet]. Updated 20. StatPearls Publishing, Treasure Island (FL); 2021. 15 p. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563279/#!po=96.6667
Touzopoulos P, Karanikas M, Zarogoulidis P, Mitrakas A, Porpodis K, Katsikogiannis N, et al. Current surgical status of thyroid diseases. J Multidiscip Healthc. 2011;4:441-449.
Sosa JA, Bowman HM, Gordon TA, et al. Importance of hospital volume in the overall management of pancreatic cancer. Ann Surg. 1998;228(3):429-438.
Haugen BR, Alexander EK, Bible KC, et al. American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-133.
Mowschenson P, Hodin R. Outpatient thyroid and parathyroid surgery: a prospective study of feasibility, safety, and costs. Surgery. 1995;118(6):1051-1054.
Spanknebel K, Chabot J, DiGiorgi M, et al. Thyroidectomy using monitored local or conventional general anesthesia: an analysis of outpatient surgery, outcome and cost in 1,194 consecutive cases. World J Surg. 2006;30(5):813-824.
Mowschenson PM, Hodin RA. Outpatient thyroid and parathyroid surgery: A prospective study of feasibility, safety, and costs. Surgery. 1995;118(6):1051-1054.
Marino M, Spencer H, Hohmann S, Bodenner D, Brendan C. Stack J. Costs of Outpatient Thyroid Surgery from the University HealthSystem Consortium (UHC) Database: Otolaryngol Neck Surg. 2014;150(5):762-769.
McHenry C. “Same-day” thyroid surgery: an analysis of safety, cost savings, and outcome. Am Surg. 1997;63(7):586-589.
Sun GH, Demonner S, Davis MM. Epidemiological and economic trends in inpatient and outpatient thyroidectomy in the United States, 1996-2006. Thyroid. 2013;23(6):727-733.
Marohn M, LaCivita K. Evaluation of total/near-total thyroidectomy in a short-stay hospitalization: safe and cost-effective. Surgery. 1995;118(6):943-948.
Service C. National Clinical Coding Standards ICD-10 4th Edition, Accurate Data for Quality Information. Health and Social Care Information Centre Leeds; 2015.
Kazaure H, Zambeli-Ljepovic A, Oyekunle T, et al. Severe hypocalcemia after thyroidectomy: an analysis of 7366 patients. Ann Surg. 2019.
Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2015. CA a cancer J Clin. 2015;65(1):5-29.
Alexander EK, Kennedy GC, Baloch ZW, Cibas ES, Chudova D, Diggans J, et al. Preoperative Diagnosis of Benign Thyroid Nodules with Indeterminate Cytology. N Engl J Med. 2012;367:705-715.
McNally Q, Richard J, Blakey K, James PW, Basilio GP, Basta NO, et al. Increasing incidence of thyroid cancer in Great Britain, 1976-2005: age-period-cohort analysis. Eur J Epidemiol. 2012;27(8):615-622.
Hu Q, Livhits M, Ko C, Yeh M. Same-day discharge is not associated with increased readmissions or complications after thyroid operations. Surgery. 2020;167(1):117-123.
Maroun C, El Asmar M, Park S, El Asmar M, Zhu G, Gourin C, et al. Drain placement in thyroidectomy is associated with longer hospital stay without preventing hematoma. Laryngoscope. 2020;130(5):1349-1356.
Torre A, Gómez N, Abuawad C, Figari M. Use of parathormone as a predictor of hypoparathyroidism after total thyroidectomy. Cir Cir. 2020;88(1):56-63.
Schwartz AE, Clark OH, Ituarte P, Lo Gerfo P. Thyroid surgery the choice. J Clin Endocrinol Metab. 1998;83(4):1097-1100.
Dedivitis R, Jr EP, Castro M, Denardin O. Analysis of safety of short-stay thyroid surgery. Acta Otorhinolaryngol Ital. 2009;29(6):326-330.