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ACS: Complications, Costs Lower for High-Volume Surgeons

Rates lower for surgeons performing 25 or more total thyroidectomies a year

THURSDAY, Oct. 8, 2015 (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 Oct. 4 to 8 in Chicago.

The study included data for 16,954 American adults who had thyroidectomy between 1998 and 2009. Overall, 6 percent of the patients had complications after their surgery. Complication rates were 4 percent among patients whose surgeon performed 25 or more total thyroidectomies a year (high-volume surgeons) and 6 percent among patients whose surgeon did fewer than 25 such surgeries a year. Only 19 percent 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 percent 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 versus one day. They also had higher hospital costs — $6,375 versus $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, M.D., chief of endocrine surgery at the Duke University Medical Center in Durham, N.C., said in a news release from the American College of Surgeons.

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