Same-Day Discharge for Pediatric Hemithyroidectomy Patients: Evaluating Safety and Barriers to Discharge.

Document Type

Article

Publication Date

8-2024

Identifier

DOI: 10.1002/ohn.726

Abstract

OBJECTIVE: Hemithyroidectomy is often performed in the pediatric population for indeterminate or benign thyroid nodules. Prior studies confirmed the safety of same-day discharge for adults undergoing hemithyroidectomy or total thyroidectomy, but this has not been studied thoroughly in the pediatric population. Our goal was to determine differences in pediatric patients undergoing hemithyroidectomy who were admitted versus discharged for complications or factors to support same-day discharge.

STUDY DESIGN: Retrospective cohort.

SETTING: Pediatric tertiary care hospital.

METHODS: This was a retrospective study of pediatric patients (0-18 years of age) undergoing hemithyroidectomy at a pediatric tertiary care hospital from 2003 to 2022. Perioperative variables and outcomes were gathered via manual chart review.

RESULTS: One hundred five pediatric patients who underwent hemithyroidectomy were identified. Ninety (86%) patients were admitted postoperatively, and 15 (14%) were discharged the same day. There were no differences in patient demographics, including age (P = 0.29) distance from the hospital (P = 0.08) or benign versus malignant pathology (P = 0.93). Surgical time in same-day discharges was significantly shorter (P = 0.0001; 138.6 minutes, SD = 66.0) versus admitted patients (204.2 minutes, SD = 48.6) Hemostatic agents were used more in same-day discharges at 53.3% versus 4.5% (P = 0.0001). Perioperative complications occurred in 2 (2.2%) admitted patients compared to none in the same-day discharge (P = 1.0). There were no readmissions within 30 days for same-day discharges.

CONCLUSION: In pediatric patients undergoing uncomplicated hemithyroidectomy, same-day discharge appears appropriate for those with shorter surgical times and intraoperative use of hemostatic agents with no readmissions or complications in those discharged the same day.

Journal Title

Otolaryngology and head and neck surgery

Volume

171

Issue

2

First Page

538

Last Page

545

MeSH Keywords

Humans; Thyroidectomy; Retrospective Studies; Child; Male; Female; Patient Discharge; Adolescent; Child, Preschool; Infant; Postoperative Complications; Ambulatory Surgical Procedures; Patient Safety; Thyroid Nodule; Operative Time; Length of Stay

Keywords

barriers; hemithyroidectomy; outpatient; pediatric thyroid; same‐day discharge

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