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Erschienen in: Journal of Anesthesia 5/2018

16.07.2018 | Original Article

Biochemically diagnosed hypothyroidism and postoperative complications after cardiac surgery: a retrospective cohort analysis

verfasst von: Ryu Komatsu, Nika Karimi, Nicole M. Zimmerman, Daniel I. Sessler, C. A. Bashour, Edward G. Soltesz, Alparslan Turan

Erschienen in: Journal of Anesthesia | Ausgabe 5/2018

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Abstract

Purpose

To determine whether hypothyroidism is associated with cardiovascular complications and surgical wound infections after cardiac surgery.

Methods

Patients were categorized as: (1) hypothyroid [patients with increased TSH concentrations (≧ 5.5 mIU/L) within 6 months prior to surgery]; (2) corrected hypothyroid [diagnosis of hypothyroidism any time before surgery or on preoperative thyroid supplementation and normal TSH concentration (0.4 \(\le\) TSH \(\le\) 5.5 mIU/L]; and (3) euthyroid [no hypothyroid diagnosis and not on preoperative thyroid supplementation and normal TSH concentrations (0.4–5.5 mIU/L)]. We conducted pairwise comparisons among the three groups using inverse probability of treatment weighting. We compared the groups on postoperative myocardial infarction, cardiac arrest, atrial fibrillation, and a composite of surgical wound infections and postoperative vasopressor use using multivariable logistic regression models. We compared the groups on ICU and hospital length of stay using Cox proportional hazards regression.

Results

Hypothyroidism was associated with a lower risk of atrial fibrillation than euthyroidism, with an estimated relative risk (99.4% CI) of 0.71 (0.56, 0.89); P < 0.001. However, none of the other pairwise comparisons on myocardial infarction, cardiac arrest, and atrial fibrillation were significant. Corrected hypothyroid patients were slightly more likely to be discharged from hospital at any given time than euthyroid patients (hazard ratios (99.6% CI), 1.18 (1.07, 1.30); P < 0.001), but no other pairwise comparisons for secondary outcomes were significant.

Conclusions

Hypothyroidism was associated with lower risk of atrial fibrillation than euthyroidism, and corrected hypothyroidism was associated with a shorter length of stay than euthyroidism.
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Metadaten
Titel
Biochemically diagnosed hypothyroidism and postoperative complications after cardiac surgery: a retrospective cohort analysis
verfasst von
Ryu Komatsu
Nika Karimi
Nicole M. Zimmerman
Daniel I. Sessler
C. A. Bashour
Edward G. Soltesz
Alparslan Turan
Publikationsdatum
16.07.2018
Verlag
Springer Japan
Erschienen in
Journal of Anesthesia / Ausgabe 5/2018
Print ISSN: 0913-8668
Elektronische ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-018-2533-5

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