The relationships of surgeon volume and specialty with outcomes following pediatric thyroidectomy
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Read the article on jpedsurg.org ↗Article · Mar 2019 · 1 min read
In brief
In brief
Study analyzing 3,149 pediatric thyroidectomy cases demonstrates that high-volume surgeons and pediatric surgical specialists achieve significantly lower complication rates compared to lower-volume surgeons and otolaryngologists. Patients with thyroid cancer and Graves' disease particularly benefit from treatment by high-volume pediatric surgeons.
Written by the GCMD Library team from the article.
Background
Previous studies of pediatric thyroidectomies suggest a volume-outcome relationship, but none have focused exclusively on pediatric surgical specialists. Our objective was to examine the effects of pediatric surgeon volume and specialty on post-thyroidectomy outcomes.
Methods
The Pediatric Health Information System was queried for patients ≤21 years who underwent partial or total thyroidectomy between 2005 and 2016. Multivariable logistic regression with propensity score weighting was used to assess the relationships between surgeon volume or specialty and 90-day thyroidectomy-specific complications. High-volume surgeons/hospitals were defined as those in the top tertile of annual thyroidectomies.
Results
The inclusion criteria were met by 3149 patients. Patients treated by higher-volume surgeons had significantly fewer complications than those treated by lower-volume surgeons (15.0% vs. 19.2%, p = 0.01). Patients with thyroid cancer also had less morbidity when treated by higher-volume surgeons compared to lower-volume surgeons (25.0% vs. 35.1%, p = 0.03), as did children with Graves' disease (19.8% vs. 29.3%, p = 0.007). Patients managed by pediatric surgeons had fewer complications than those managed by pediatric otolaryngologists across all patients (14.0% vs. 22.5%, p