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

作者：Morton Randall P^*; Vandal Alain C

来源：Clinical Otolaryngology, 2015, 40(5): 462-467.

DOI：10.1111/coa.12407

Objectives To examine potential factors that may predict development of postoperative haematoma following thyroid surgery, with particular attention to postoperative systolic blood pressure.
Design Retrospective, observational case-control study of patients undergoing thyroid surgery.
Setting Secondary General Hospital.
Participants Patients attending Counties Manukau District Health Board (CMDHB) between 2002 and 2012.
Main Outcome Measures Post-operative Haematoma formation that required re-exploration of the wound.
Results 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).
Conclusions This study identifies postoperative hypertension as significantly related to development of early postoperative haematoma. Cause for late post-thyroidectomy bleeding remains speculative.

• 出版日期2015-10