Impact of psychiatric comorbidities on outcomes related to thyroid and parathyroid operations

Background: We examined the effect of psychiatric comorbidities on perioperative surgical outcomes and the leading causes of readmissions in patients who underwent thyroid and parathyroid operations. Method: Patient information was retrieved from the Nationwide Readmission Database (2010–2017). Multivariate analysis was used to identify predictors for hospital readmissions. Results: A total of 181,007 and 53,808 patients underwent thyroid and parathyroid operations, respectively. Of those, 8,468 (4.7%) and 6,112 (11.4%) patients were readmitted within 30 days. Psychiatric comorbidities were more frequent in readmitted cohorts after thyroidectomies (14.9% vs 10.4%; P < .001) and parathyroidectomies (16.8% vs 11.5%; P < .001), with anxiety being the most frequent cause (thyroid: 7.87%, parathyroid: 6.8%). Psychiatric comorbidities were associated with greater risk of in-hospital mortality (thyroid: odds ratio = 2.07, 95% confidence interval = 1.13–3.53; P = .015 and parathyroid: odds ratio = 1.67, 95% confidence interval = 1.04–2.70; P = .005), postoperative complications (thyroid: odds ratio = 1.528, 95% confidence interval = 1.473–1.585; P < .001 and parathyroid: odds ratio = 3.26, 95% confidence interval = 2.84–3.73; P < .001), prolonged duration of stay (thyroid: beta coefficient = 1.142, 95% confidence interval = 1.076–1.207; P < .001 and parathyroid: beta coefficient = 2.15, 95% confidence interval = 1.976–2.32; P < .001), and 30-day readmissions (thyroid: hazard ratio = 1.18, 95% confidence interval = 1.03–1.18; P = .047 and parathyroid: hazard ratio = 1.23, 95% confidence interval = 1.11–1.36; P < .001). Psychosis had the greatest risk of readmission (thyroid: hazard ratio = 1.51 and parathyroid: hazard ratio = 1.42), and dementia (odds ratio = 2.58) had the greatest risk of postoperative complications. Conclusion: Concomitant psychiatric conditions after thyroid and parathyroid operations were associated with increased risk of postoperative complications, prolonged hospital stays, and greater rates of readmissions.