Evidence map›Paper›PMID 32430544›Full record

ArticleDer Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen2021

[Case volume and complications after thyroid gland surgery in Germany: an analysis of routine data from 48,387 AOK patients].

M Maneck, C Dotzenrath, H Dralle, C Fahlenbrach, T Steinmüller, D Simon, E Tusch, E Jeschke, C Günster

Abstract read
PubMed Publisher
In one paragraph

Article in Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

M ManeckWissenschaftliches Institut der AOK, Rosenthaler Str. 31, 10178, Berlin, Deutschland. Matthias.Maneck@wido.bv.aok.de.
C DotzenrathKlinik für Endokrine Chirurgie, Helios Universitätsklinikum Wuppertal, Wuppertal, Deutschland.
H DralleKlinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Endokrine Chirurgie, Universitätsklinikum Essen, Essen, Deutschland.
C FahlenbrachAOK-Bundesverband, Berlin, Deutschland.
T SteinmüllerKlinik für Allgemein- und Viszeralchirurgie, DRK Kliniken Westend, Berlin, Deutschland.
D SimonKlinik für Allgemein- und Viszeralchirurgie, Thoraxchirurgie und Endokrine Chirurgie, Ev. Krankenhaus BETHESDA, Duisburg, Deutschland.
E TuschMedizinischer Dienst der Krankenversicherung Berlin-Brandenburg, Berlin, Deutschland.
E JeschkeWissenschaftliches Institut der AOK, Rosenthaler Str. 31, 10178, Berlin, Deutschland.
C GünsterWissenschaftliches Institut der AOK, Rosenthaler Str. 31, 10178, Berlin, Deutschland.
Wissenschaftliches Institut der AOK · DEBundesverband Glaukom-Selbsthilfe · DEDRK Kliniken Berlin · DEGerman Society of Medical Intensive Care and Emergency Medicine · DEHelios Universitätsklinikum Wuppertal · DERuhrlandklinik · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany studies showed that hospital and surgeon volume have a significant influence on the complication rates of thyroid surgery. The present study investigates whether this relationship applies in subtotal as well as total lobe resections. Furthermore, it is still unclear which threshold for the hospital-related case volume can be determined, above which the risk of complications lies below the current national average. MATERIAL AND

methodsThe study was based on nationwide routine data for persons insured with the Local General Sickness Fund (AOK) who had undergone thyroid surgery in 2014-2016. Permanent vocal cord palsy, bleeding and wound infection needing revision were recorded using indicators. The effect of the case volume on the indicators and the case number threshold was determined using logistic regression.

resultsPermanent vocal cord palsy was observed in 1.3% and bleeding or wound infections needing revision in 1.6% and 0.3% of the cases. Compared to hospitals with >450 surgeries per year, the risk of permanent vocal cord palsy in hospitals with fewer than 201, 101 and 51 surgeries was significantly increased (OR [95% CI]: 1.5 [1.1-2.1]; 1.5 [1.1-2.1]; 1.8 [1.3-2.5]). The threshold needed to achieve a risk for permanent vocal cord palsy below the national average (1.3%) was 265 thyroid surgeries per year (95% CI: 110-420). For bleeding or wound infection in need of revision, no association between volume and outcome was found.

conclusionThe present study showed that the risk of postoperative permanent vocal cord palsy decreased with increasing case volume. The broad confidence interval of the threshold makes clear case volume recommendation difficult. In order that the risk for a postoperative permanent vocal cord palsy is not likely above the national average, the annual case volume should reach 110 thyroid interventions.

Indexed as

Thyroid GlandVocal Cord ParalysisGermanyHumansPostoperative ComplicationsThyroidectomyBenign goiterCase number thresholdRoutine dataVocal cord palsyVolume outcome

Identifiers

PMID32430544
OpenAlexW3028206008

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.