Predictors of post-thyroidectomy complications, a tertiary centre experience: A retrospective cohort study.

Purpose: Thyroidectomy is currently a common elective surgical procedure associated with a wide range of complications,from unnoticed events to lifelong problems and even life-threatening complications. The most troublesome events arebleeding, nerve injuries, and hypocalcaemia. The present study was conducted to report the incidence and predictivefactors for perioperative complications, aiming to identify preventive measures.Patients and Methods: A retrospective study of 241 patients who underwent elective thyroidectomy between 2013 and2023. The incidence and types of complications were the primary outcomes, and the predictive factors for complicationswere the secondary outcomes. Patient demographic and perioperative data were collected, tabulated, and analyzedby SPSS version 26. Univariate analysis was performed with the chi-square test for factors predicting perioperativecomplications, and statistically significant factors were further analyzed by multivariate logistic regression analysis todetermine the most significant factor.Results: This study included 241 patients; 183 (75.8%) were females, 170 (71.5%) patients had thyroid cancer, and 71(29.5%) patients had benign thyroid lesions. The mean hospital stay after surgery was 2 days, and one case of hospitaldeath was reported (0.4%).The overall postoperative complication rate was 34.4%. The most frequent complications were hypocalcaemia (19.9%),recurrent laryngeal nerve injury (2.45%), and bleeding (4.1%). The other complications reported were pneumothorax,surgical site infection (SSI), seroma, and chyle leakage.The predictors of post-thyroidectomy complications were advanced age greater than or equal to 60 years (P=0.003*),prior thyroid surgery (P<0.001*), and lymph node dissection with total thyroidectomy (P= 0.01*) according to univariateanalysis. Multivariate analysis revealed that advanced age (P=0.02*) and prior thyroid surgery (P<0.001*) were the mainsignificant predictors of complications.Conclusion: Thyroid surgery is generally a safe procedure with acceptable surgical outcomes. Transient hypocalcaemiais the most frequent post thyroidectomy complication. Advanced age and prior thyroid surgery were the main significantpredictors of overall post-thyroidectomy complications. Neck dissection with total thyroidectomy is safe but has a higherincidence of hypocalcaemia than thyroidectomy alone. Consequently, every effort should be made to avoid reoperationby performing a wise definitive initial treatment.