Post-Thyroidectomy Complications at St Paul’s Hospital Millennium Medical College, Ethiopia: Associated Factors and Outcomes

Figures & data

Table 1 Sociodemographic and Chief Complaints at Presentation of Post-Thyroidectomy Patients at SPHMMC from January 2019 to December 2021

Variable	Category	Frequency	Percent
Sex	Male	28	10.7
	Female	234	89.3
	Total	262	100.0
Age category	<20	5	1.9
	20–40	149	56.9
	41–60	91	34.7
	>60	17	6.5
	Total	262	100.0
Anterior neck swelling	Yes	260	99.2
	No	2	0.8
	Total	262	100.0
Compressive symptoms	Yes	52	19.8
	No	210	80.2
	Total	262	100.0
Toxic symptoms	Yes	101	38.5
	No	161	61.5
	Total	262	100.0
Change of voice	Yes	5	1.9
	No	257	98.1
	Total	262	100.0
Weight loss	Yes	8	3.1
	No	254	96.9
	Total	262	100.0

Figure 1 Preoperative diagnosis of post-thyroidectomy patients at SPHMMC from January 1, 2019 to December 31, 2021.

Table 2 Immediate Post-Operative Day Complications in Post-Thyroidectomy Patients

Immediate Postoperative Complications	Frequency (n)	Percent (%)
Hematoma collection	10	21.7
Hoarseness of voice	14	30.4
Symptomatic hypocalcemia	30	65.2
Seroma collection	0	0
Difficulty of swallowing	3	6.5
Airway obstruction	1	2.2

Figure 2 Overall post-thyroidectomy complications at first (within 1 to 2 weeks postoperative) follow up visit.

Table 3 Cross Tabulation of Complications and Type of Thyroidectomy at 6-Month Postoperative Follow-Up Visit

Complication at 6th Month Postoperative Follow-Up		Type of Thyroidectomy Performed by Patient’s Number (n)					Total (n*)
		Lobectomy + Isthmusectomy(n)	Dunhill’s Procedure(n)	STT (n)	TT (n)	Completion Thyroidectomy (n)
Hypothyroidism	Yes	5	14	12	7	0	38
RLN palsy	Yes	1	2	3	1	0	7
Hypocalcemia	Yes	0	2	4	9	1	16
Dysphonia	Yes	0	1	1	0	0	2
Total							63

Notes: *Nine patients had two complications each (six had hypothyroidism with hypocalcemia and three had hypothyroidism with RLN injury). The number of patients with complication at 6 months was 54.

Table 4 Cross Tabulation of Complications at 6-Month Follow-Up and Level of Expertise of Operating Surgeon

Variables		Level of Expertise of the Surgeon		Total
		General Surgeon	EBS + Fellow
RLN identified intraoperatively	Yes	53	35	88
	No	165	9	174
	Total	218	44	262
Parathyroid gland identified intraoperatively	Yes	24	20	44
	No	194	24	218
	Total	218	44	262
RLN palsy	Yes	7	0	7
	No	37	10	47
	Total	44	10	54
Hypocalcemia	Yes	13	3	16
	No	31	7	38
	Total	44	10	54
Dysphonia	Yes	2	0	2
	No	42	10	52
	Total	44	10	54

Figure 3 Post-thyroidectomy complications at 6-month postoperative follow-up visit.

Table 5 Summary of Bivariable and Multivariable Analysis of Variables Associated with Post-Thyroidectomy Complications on First Follow-Up Visit

Variable	Category	Complication on 1st Follow-Up Visit		COR (95% CI)	P-value	AOR (95% CI)	P-value
		No, n (%)	Yes, n (%)
Sex of the patient	Male	25 (13.5)	3 (3.9)
	Female	160 (86.5)	74 (96.1)	3.85 (1.13, 13.17)	0.031	3.36 (0.85, 13.23)	0.083
Compressive symptoms	Yes	41 (22.2)	11 (14.3)	0.59 (0.28, 1.21)	0.149	0.55 (0.24, 1.27)	0.162
	No	144 (77.8)	66 (85.7)
Preoperative diagnosis	Benign	142 (76.8)	61 (79.2)
	Malignant	20 (10.8)	12 (15.6)	1.40 (0.64, 3.03)	0.399	1.40 (0.52, 3.79)	0.506
	Follicular Neoplasm	23 (12.4)	4 (5.2)	0.40 (0.13, 1.22)	0.108	0.42 (0.11, 1.59)	0.201
Type of thyroidectomy	Partial	118 (63.8)	36 (46.8)
	Sub-total	21 (11.4)	19 (24.7)	2.97 (1.44, 6.12)	0.003	2.89 (1.29, 6.50)	0.01
	Total	46 (24.9)	22 (28.6)	1.57 (0.83, 2.94)	0.162	1.59 (0.69, 3.66)	0.271
RLN identified intraoperatively	Yes	70 (37.8)	18 (23.4)
	No	115 (62.2)	59 (76.6)	2.00 (1.09, 3.66)	0.025	1.80 (0.85, 3.80)	0.125