ASSOCIATION OF PREOPERATIVE THYROID HORMONE REPLACEMENT WITH PERIOPERATIVE COMPLICATIONS AFTER MAJOR ABDOMINAL SURGERY
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Keywords
Thyroid hormone replacement therapy, hypothyroidism, major abdominal surgery, perioperative complications.
Abstract
Background: Thyroid hormones control metabolism; an imbalance in these hormones, especially hypothyroidism, may have an effect on overall health. Preoperative management of major abdominal surgery outcomes requires an understanding of their involvement.
Objective: The objective of this study was to investigate the association between preoperative thyroid hormone replacement therapy and the incidence of perioperative complications in patients undergoing major abdominal surgery.
Methodology: A retrospective cohort analysis of 390 patients receiving major abdominal surgery was performed as part of the research at DHQ Teaching Hospital Timergara, Pakistan. Patients who were eighteen years of age or older were included in the study, and careful data collecting from computerized records ensured a thorough analysis. Pancreatic resections, hepatotectomies, and colectomies were among the surgical techniques used. Logistic regression was used to examine patient demographics, thyroid function, surgery details, and perioperative outcomes after controlling for variables.
Results: The research, involving 390 individuals, examined perioperative complications in major abdominal surgery. Patients were predominantly aged 40-59 (57.18%), with 12.31% below 40 and 30.51% over 60, averaging 55.8 years. The cohort comprised 47.18% females and 52.82% males. Mean BMI was 27.6 kg/m², with 24.62% having BMI < 25, 53.33% between 25-29.9, and 22.05% ≥ 30. Common comorbidities included hypertension (30.26%) and diabetes (24.10%). Hypothyroidism was diagnosed in 16.41% of patients, with 11.03% on thyroid hormone replacement. Hypothyroidism correlated significantly with complications (OR 1.82, p < 0.001), while thyroid hormone replacement trended towards reducing complications (OR 0.68, p = 0.054). Older age, male sex, and comorbidities also showed significant associations with complications.
Conclusion: The optimization of perioperative care techniques should take into account the potential for problems during major abdominal surgery to be mitigated by preoperative thyroid hormone replacement.
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Muhammad Zeb
Consultant General Surgeon, Surgical Department, DHQ Teaching Hospital, Timergara, Pakistan
Muhammad Rashid Waheed
Registrar, General Surgery Department, Khyber Teaching Hospital, Peshawar, Pakistan
Mohamed Ahmed Aref Ahmed
Specialist, General Surgery Department, SKMC, UAE
Taher Helmy Aldesouky
Consultant General Surgeon, Saudi German Hospital Ajman, UAE
Muhammad Umair Sultan
Medical Officer, Ahmad Hospital, Sheikhupura, Pakistan
Fazli Akbar
Associate Professor, Surgical A Ward, Saidu Group of Teaching Hospitals, Swat, Pakistan
Aaliya Javed
Doctor, Liaquat National Hospital & Medical College, Karachi, Pakistan
Nusrum Iqbal
Chairman Department of Internal Medicine, MD Health Center, Lahore, Pakistan
Ehsan Ullah
Consultant General and Laparoscopic Surgeon, General Surgery Department, Irfan General Hospital, Charsadda Road Peshawar, Pakistan