(0727) Sex-Specific Differences in 30-Day Outcomes of Morbidly Obese Patients Undergoing Thyroidectomy

Introduction: This study specifically investigates the association between gender and complications in thyroidectomy based on obesity status.

Methods: The National Surgical Quality Improvement Program (NSQIP) database was retrospectively queried for patients who underwent thyroidectomy between 2005 and 2018. Univariate and multivariable analyses were conducted to determine associations between gender and postoperative complications separated by obesity status.

Results: 97,795 patients undergoing thyroidectomy were queried with an obese population of 45,358 patients, of which 36,142 (79.7%) were obese females and 9,216 (20.3%) were obese males. On univariate analysis, in the non-obese population only, males were more likely than females to be smokers, have ventilator use, COPD, CHF, dialysis, and steroid use. Upon multivariable analyses, males had higher morbidity rates than females in both the obese (OR=2.348, CI:1.106-4.987, p=0.026) and non-obese populations (OR=1.437, CI:1.021-2.025, p=0.038). However, in the obese population only, males were more likely to have cumulative wound complications (OR=6.664, CI:1.566-28.357, p=0.010) and deep surgical site infection (OR=6.043, CI:1.744-388.881, p=0.018).

Conclusions: The non-obese population has larger differences in comorbidity incidence between the sexes, with higher associated comorbidities present in males. However, only within the obese population is the risk of developing a postoperative complication higher among men, revealing a significant association between sex and outcomes of thyroidectomy based on obesity status.