Volume-Based Trends in Thyroid Surgery
作者： Christine G. Gourin , Ralph P. Tufano , Arlene A. Forastiere , Wayne M. Koch , Timothy M. Pawlik
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摘要: Objective To characterize contemporary patterns of thyroid surgical care and variables associated with access to high-volume care. Design Cross-sectional analysis. Setting Maryland Health Service Cost Review Commission database. Patients Adults who underwent surgery for disease in between January 1, 1990, July 2009. Results Overall, 21 270 procedures were performed by 1034 surgeons at 51 hospitals. Procedures increased from 15.7% 1990-1999 30.9% 2000-2009 (odds ratio [OR], 3.69; P = .002), hypocalcemia (0.62; = .01). After controlling other variables, was (OR, 1.76; = .02) but less likely be cancer (0.83; Conclusions The proportion hospitals significantly 2000-2009, an increase total thyroidectomy neck dissection. Surgeon volume complication rates. Thyroid despite cases. Further investigation is needed identify factors contributing this trend.
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