Imperial College London
Alternate

Professor the Lord Darzi of Denham PC KBE FRS FMedSci HonFREng

Faculty of Medicine, Department of Surgery & Cancer

Co-Director of the IGHI, Professor of Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1310a.darzi

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Nouraei:2016:10.1111/coa.12730,
author = {Nouraei, SA and Virk, JS and Middleton, SE and Aylin, P and Mace, A and Vaz, F and Kaddour, H and Darzi, A and Tolley, NS},
doi = {10.1111/coa.12730},
journal = {Clinical Otolaryngology},
pages = {354--365},
title = {A national analysis of trends, outcomes and volume-outcomes relationships in thyroid surgery},
url = {http://dx.doi.org/10.1111/coa.12730},
volume = {42},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: Thyroid conditions are common and their incidence is increasing. Surgery is the mainstay treatment for many thyroid conditions, and understanding its utilisation trends and morbidity are central to improving patient care. DESIGN: An N=near-all analysis of the English administrative dataset to identify trends in thyroid surgery specialisation, volume-outcome relationships, and the incidence and risk factors for short- and long-term morbidity. MAIN OUTCOME MEASURES: Between 2004 and 2012, 72594 patients underwent elective thyroidectomy in England. Information about age, sex, morbidities, thyroid disease and surgery, adjuvant treatments, and complications including hypocalcaemia and vocal palsy were recorded. RESULTS: Mean age at surgery was 49±30 and a female predominance (82%) was observed. Most patients underwent hemithyroidectomy (51%) or total thyroidectomy (32%). Patients underwent surgery for benign (52.5%), benign inflammatory (21%), and malignant (17%) thyroid diseases. Thyroid surgery grew by 2.9% a year and increased in specialization. Increased surgeon volume significantly reduced lengths of stay: the proportion of length of stay outliers fell from 11.8% for patients of occasional thyroidectomists (<5 per year) to 2.8% for patients of high-volume surgeons (>50 thyroidectomies a year). Post-discharge vocal palsy and hypocalcaemia occurred in 1.87% and 1.58% of cases respectively. High-volume surgeons had a reduced incidence of vocal palsy and volumes >30 were consistently protective. CONCLUSIONS: Thyroid surgery is increasingly specialised. High-volume surgeons achieve lower complications rates, including lower vocal palsy rates, and length of stay. This article is protected by copyright. All rights reserved.
AU  - Nouraei,SA
AU  - Virk,JS
AU  - Middleton,SE
AU  - Aylin,P
AU  - Mace,A
AU  - Vaz,F
AU  - Kaddour,H
AU  - Darzi,A
AU  - Tolley,NS
DO  - 10.1111/coa.12730
EP  - 365
PY  - 2016///
SN  - 1749-4486
SP  - 354
TI  - A national analysis of trends, outcomes and volume-outcomes relationships in thyroid surgery
T2  - Clinical Otolaryngology
UR  - http://dx.doi.org/10.1111/coa.12730
UR  - http://hdl.handle.net/10044/1/41741
VL  - 42
ER  -
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