Risk Factors for Prolonged Hospital Stay and 90-Day Readmission After Thyroidectomy in the Pediatric Population: A Nationwide Readmissions Database 2016-2020 Analysis.

OBJECTIVES

Thyroidectomy in children, though uncommon, is indicated for malignancies, benign goiters, and hyperthyroidism. While generally safe, concerns remain regarding postoperative complications, prolonged hospitalization, and readmission. However, large-scale data on risk factors for these outcomes in pediatric patients are limited. This study aimed to identify factors associated with prolonged hospital stay and 90-day readmission using a nationally representative database.

METHODS

Data from the Nationwide Readmissions Database from 2016 to 2020 were retrospectively analyzed. Children 1-19 year old who underwent thyroidectomy were included in this study. Prolonged length of stay (LOS) was defined as LOS at or above the 75th percentile. Multivariable logistic regression using backward selection identified factors independently associated with prolonged LOS and 90-day readmission.

RESULTS

A total of 871 pediatric thyroidectomy cases were identified, representing 2081 weighted admissions. The mean age of the patients was 14.6 years, and 75% were female. Total thyroidectomy (adjusted odds ratio [aOR] = 2.61), emergent surgery (aOR = 2.58), diabetes mellitus (aOR = 2.55), postoperative hypocalcemia (aOR = 3.05), and respiratory failure (aOR = 10.37) were associated with prolonged LOS. Factors associated with increased risk of 90-day readmission were male sex (aOR = 2.80), total thyroidectomy (aOR = 2.65), autoimmune disease (aOR = 3.28), postoperative hypocalcemia (aOR = 1.90), and postprocedural pain (aOR = 3.33).

CONCLUSIONS

This study identified key risk factors for prolonged hospitalization and readmission after thyroidectomy in children. These findings may support tailored perioperative strategies to improve outcomes and optimize health care resource utilization in this population.