Prevalence and Factors for postoperative complications after Total Thyroidectomy in Krabi Hospital

Abstract

Background: Total thyroidectomy is widely performed regarded as a safe treatment option; however, postoperative complications such as hypocalcemia and recurrent laryngeal nerve injury may still occur.
Objective: This study aimed to determine the prevalence of postoperative complications and identify associated factors among patients undergoing total thyroidectomy at Krabi Hospital, with the goal of informing postoperative surveillance and reducing both the incidence and severity of complications.
Methods: This retrospective study included 149 patients who underwent total thyroidectomy at Krabi Hospital between January 1, 2020, and December 31, 2024. Data were collected from medical records on patient characteristics, operative details, and postoperative complications assessed at 24 hours, 1 month, 3 months, and 6 months following surgery. Descriptive statistics and inferential analyses, including logistic regression, were used to evaluate factors associated with complications.
Result: Transient hypocalcemia was the most common complication 41.61%)and was associated with female sex (p-value=0.032, OR 1.17, 95%CI 0.09-2.24). The second most frequent complication was transient recurrent laryngeal nerve (RLN) injury 30.87%, with female sex (p-value=0.044, OR 5.37, 95%CI 1.04-27.71) identified as risk factors. Permanent RLN injury occurred in 11.41% of patients, particularly among those with intraoperative blood loss ≥100 ml (p-value=0.002, OR 5.82, 95%CI 1.94-17.44). Permanent hypocalcemia occurred in 7.38% of patients and was significantly associated with age ≥45 years (p-value=0.027, OR 6.17, 95%CI 1.23-30.87). Only one case of surgical site infection was observed, and no cases of postoperative hematoma were reported.
Conclusion: The most common complications following total thyroidectomy were transient hypocalcemia and transient recurrent laryngeal nerve injury. High-risk patients should receive appropriate pre- and postoperative counseling particularly regarding symptom recognition, calcium monitoring, and voice changes and should be closely monitored after surgery to prevent or reduce the severity of potential complications.