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Objective: Describe data from patients undergoing outpatient thyroid surgeries for benign and malignant disease at academic medical centers in the United States., Study Design: Retrospective database search., Setting: The University Health System Consortium (UHC), Oak Brook, Illinois, data compiled from discharge summaries., Subjects and Methods: Discharge data were collected from the first quarter of 2005 through the fourth quarter of 2010. Searching strategy was based on diagnosis of thyroid disease and patients undergoing thyroid surgery across all UHC facilities. Demographic information was collected as well as charges. Complications were also evaluated in this analysis., Results: During the study period, 38,362 outpatient thyroidectomies were performed from our sample, 32% for thyroid cancer. More total thyroidectomies (43%) and fewer hemithyroidectomies (36%) were being performed overall; 64.1% of patients stayed 23 hours., Conclusion: This is one of the largest series reporting outcomes for outpatient thyroid surgery. Since these surgeries appear to be shifting to an outpatient setting, this report reflects the experience with the majority of endocrine surgeries from the UHC database being performed presently. These results are derived from teaching hospitals and their affiliates and may not reflect the entirety of thyroid surgery in the United States.

Objective: To determine demographics and cost for outpatients undergoing parathyroid surgery at hospitals belonging to the University Health System Consortium (UHC)., Study Design: UHC data were accessed in 2011 and reflected data collected from 2005 through 2010 (24 quarters). Searching strategy was based on diagnoses of parathyroid disease and patients undergoing parathyroidectomy across all UHC member facilities. Complications evaluated in this analysis included: hypocalcemia, hypoparathyroidism, aspiration pneumonia, hematoma, wound infection, stroke, myocardial infarction, deep venous thrombosis/pulmonary embolism (PE), and death., Setting: The University Health System Consortium, Oak Brook, Illinois, was formed in 1984 and consists of 112 academic medical centers and 250 of their affiliated hospitals. This represents 90% of the nonprofit academic medical centers in the United States (www.uhc.edu)., Subjects and Methods: Patients enrolled in the UHC database were studied retrospectively. Data were compiled from discharge summaries into a secure, interactive, Web-based database. The outpatient data collection set has been a recent addition to the originally established UHC inpatient discharge database., Results: There were 21,057 patients who had outpatient parathyroid surgery. The average age was 59.0 (0.8-96.2) yrs. Seventy-six percent of patients were female. Outpatient parathyroidectomy had lower charges than inpatient surgery ($12,738 and $14,657, respectively; P = 0.004, Wilcoxon signed-rank test). Complications were low but were likely underreported., Conclusion: Parathyroid surgery is increasingly being done in the outpatient setting in the United States. By virtue of omitting inpatient hospitalization, the outpatient approach becomes a more economical way to manage parathyroid disease. This is the largest known series reporting experience with outpatient parathyroid surgery.

Objective: Describe data from patients undergoing thyroid surgeries for benign and malignant disease at US academic medical centers., Study Design: Retrospective, database search., Setting: The University Health System (UHC) Consortium (Oak Brook, Illinois) data compiled from discharge summaries., Subjects and Methods: Discharge data were collected from the first quarter of 2002 through the fourth quarter of 2009. Searching strategy was based on diagnosis of thyroid disease and patients undergoing thyroid surgery across all UHC facilities. Demographic information was collected as well as length of stay (LOS) and costs. Complications were evaluated in this analysis., Results: During the study period, 68,014 thyroidectomies were performed, with 27,200 for thyroid cancer. During the same period 6365 neck dissections were performed, with 1539 as stand-alone procedures. Total thyroidectomy was the procedure of choice for malignant disease. More total thyroidectomies and fewer hemithyroidectomies were being performed for benign thyroid disease in the inpatient setting. Almost all postoperative complications were more frequent after surgery for cancer except myocardial infarction and aspiration pneumonia. On average, LOS was longer for benign disease, but costs were higher for malignant disease., Conclusion: This is the largest series reporting inpatient LOS and mortality for thyroid surgery. The limitation of this study is that it reports patients whose stays were more than 23 hours, leaving out a significant number of thyroid surgeries that are performed as outpatients. Although the results contribute greatly to characterizing inpatient surgery, the results may not reflect current US trends for thyroid surgery.