ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
BMI threshold associates with increased 30-day complications after total thyroidectomy surgery.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe relationship between obesity and postoperative complications following total thyroidectomy remains unclear, with prior studies relying on traditional BMI categorizations that may inadequately capture risk. This study aims to define datadriven BMI thresholds associated with 30-day postoperative complications.
methodsNational Surgical Quality Improvement Program (ACS-NSQIP) database (2005-2019). Adult patients undergoing total thyroidectomy (CPT-60240) were included. Stratumspecific likelihood ratio (SSLR) analysis was used to identify BMI thresholds associated with 30-day all-cause complications. Multivariate logistic regression controlled for demographic and clinical confounders.
resultsA total of 76,448 patients met inclusion criteria. SSLR analysis identified a BMI threshold of ≥42 as associated with increased complication risk. Patients with BMI ≥42 demonstrated higher rates of all-cause complications (2.22% vs. 1.60%, p=0.001), major complications (1.33% vs. 0.92%, p=0.004), surgical site infections, pulmonary complications, and unplanned reintubation. On multivariate analysis, BMI ≥42 remained an independent predictor of all-cause complications (OR 1.26, 95% CI 1.02-1.55), major complications (OR 1.30, 95% CI 1.00-1.71), and pulmonary complications (OR 1.53, 95% CI 1.14-2.07).
conclusionA BMI threshold of ≥42 is independently associated with increased 30-day morbidity, following total thyroidectomy. These findings support a shift toward data-driven BMI, stratification to improve preoperative risk assessment and perioperative management in thyroid surgery.
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