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  • Title: Complications and indications for intensive care unit admission after thyroidectomy in a University Teaching Hospital.
    Author: Kolawole IK, Olurode YA.
    Journal: Niger Postgrad Med J; 2009 Jun; 16(2):149-53. PubMed ID: 19606196.
    Abstract:
    BACKGROUND: Routine admission of all post-thyroidectomy patients into intensive care unit (ICU) within the first 24-48 hours is advocated and practised in some hospitals. However, clinicians today are faced with the need to improve patient outcome at minimal costs. AIMS: To determine the incidence of life-threatening complications necessitating (ICU) admission following thyroidectomy; and to identify any pre-operative risk factors for ICU admission in patients with goitre. SETTING: University of Ilorin Teaching Hospital, Ilorin, Nigeria. DESIGN: Retrospective study. METHODOLOGY: A retrospective study of all patients who were admitted to the ICU following thyroidectomy, over a period of 10 years (January 1993- December 2002), was carried out. Their records were analysed for indication for admission, therapeutic intervention instituted and outcome. RESULTS: A total of 196 case notes out of the 210 thyroidectomies performed within the study period could be retrieved for analysis. Twenty patients (10.2%) required ICU admission for various indications. Sixteen of the admissions were elective based on recognition of the need immediately after extubation in the theatre, while the remaining 4 patients were emergency admissions transferred from the post-surgical ward at variable periods within the first 24-hours post-operatively. The most common reason for ICU admission was recurrent laryngeal nerve (RLN) palsy, which occurred in 13 patients (6.6%). There was one mortality in the elective admissions and no mortality in emergency admissions. No patient died or suffered disability on account of failure to get admitted to ICU. CONCLUSION: It is safe to discharge the majority of patients back to post-surgical ward for nursing care immediately after thyroidectomy. Most of our patients were discharged to the post-surgical ward without any life-threatening complication.
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