MON-403 The Burden Of Post-thyroidectomy Fatigue In Benign Nodular Thyroid Disease: A Healthcare Utilization And Cost Analysis

Abstract Disclosure: C.B. Jensen: None. S. Xie: None. A. Sinha: None. H. Nathan: None. R.A. Greenup: None. S.C. Pitt: None. Introduction: Fatigue is a common patient complaint after thyroidectomy, yet little is known about its impact on healthcare utilization and costs. This study aimed to evaluate the association between new-onset fatigue, subsequent healthcare utilization, and out-of-pocket costs following thyroidectomy for benign nodular thyroid disease. Methods: This retrospective cohort study compared adults with new-onset fatigue to those without fatigue using MarketScan data (2009-2022). New-onset fatigue was defined as >2 ICD-coded claims within one year postoperatively. Patients with pre-existing fatigue, thyroid cancer, autoimmune thyroid disease, or concurrent parathyroidectomy were excluded. Entropy balancing was performed to obtain a weighted comparison, adjusting for differences in demographic and clinical characteristics. Healthcare utilization (defined as inpatient admissions, emergency department [ED] visits, and outpatient visits) and total out-of-pocket costs were compared using independent sample t-tests. Results: Of 18,395 patients included, 15.1% (n=2,769) had new onset fatigue. The balanced cohorts had a mean age of 50.2 years, were 83.9% (n=2324) female, and 63.7% (n=1763) underwent thyroid lobectomy. In the year post-thyroidectomy, patients with new-onset fatigue had significantly more healthcare visits than those without fatigue (50.0 ±34.6 vs. 45.1 ± 37.0 total visits per patient, respectively, p<0.001). This higher utilization was driven by more outpatient visits (22.5 ± 18.1 vs. 16.5 ± 15.4, p<0.001), ED visits (1.8 ± 1.8 vs. 1.7 ± 2.0, p=0.001), and inpatient admissions (1.3 ±0.7 vs. 1.1 ± 0.5, p<0.001). Average out-of-pocket costs at one-year post-thyroidectomy were lower for patients with new-onset fatigue compared to those without (-$23, p<0.001). Increased healthcare utilization, yet lower total costs, were evident even at 3 months post-thyroidectomy for patients with new-onset fatigue (both p<0.001). Conclusion: New-onset fatigue post-thyroidectomy for benign thyroid disease is associated with significantly greater healthcare utilization. Although out-of-pocket costs were lower for patients with new-onset fatigue post-thyroidectomy, the unmeasured indirect costs of increased outpatient visits, ED visits, and hospital admissions are likely substantial. Presentation: Monday, July 14, 2025