ACS: Complications, Costs Lower for High-Volume Surgeons
(HealthDay News) — Patients who undergo thyroidectomy are less likely to suffer complications if their surgeon performs many such surgeries each year, according to a study presented at the annual meeting of the American College of Surgeons, held from October 4–8 in Chicago.
The study included data for 16,954 American adults who had thyroidectomy between 1998–2009. Overall, 6% of the patients had complications after their surgery. Complication rates were 4% among patients whose surgeon performed 25 or more total thyroidectomies a year (high-volume surgeons) and 6% among patients whose surgeon did fewer than 25 such surgeries a year. Only 19% of the patients in the study were operated on by high-volume surgeons. The median number of total thyroidectomies performed by surgeons was seven.
The researchers calculated that patients undergoing the operation by a surgeon who performed only one thyroidectomy per year had a 65% increased risk of complications, compared to patients of high-volume surgeons. More than half the surgeons in the study performed just one thyroidectomy per year. While the researchers only found an association between a physician's surgery rates and thyroidectomy complications, they reported that, on average, patients with low-volume surgeons had twice as long a hospital stay – two days vs. one day. They also had higher hospital costs – $6,375 vs. $5,863.
"Although the surgeon's experience is one of the most predictive factors for patient outcomes from total thyroidectomy, the number of cases that defines a high-volume thyroid surgeon was unclear," senior investigator Julie Ann Sosa, MD, chief of endocrine surgery at the Duke University Medical Center in Durham, NC, said in a news release from the American College of Surgeons.