{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T22:49:53Z","timestamp":1784933393789,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bleeding after thyroid and\/or parathyroid surgery is a life\u2010threatening emergency. The aim of this study was to determine the rates of reoperation following bleeding, identify risk factors, assess management strategies and outcomes, and develop protocols to reduce risk and improve management of bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of all consecutive patients who underwent thyroid and\/or parathyroid surgery over a 7\u2010year period was conducted. A nested case\u2013control design was used to evaluate specific factors and their association with reoperation for bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1913 patients, 25 (1.3%) underwent reoperation for bleeding. Of the 25 patients who bled, 6 (24%) required reoperation before leaving theatre; 17 (68%) had bleeding within 6 h, 1 (4%) between 6 and 24 h, and 1 (4%) after 24 h. Reoperation for bleeding was not associated with age, gender, or surgeon. Patients who had total thyroidectomy were more likely to have reoperation for bleeding compared to hemithyroidectomy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045) or parathyroidectomy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). The following factors were not associated with bleeding: neck dissection, re\u2010do surgery, drain use, blood\u2010thinning medication or clotting disorders, and BMI. Patients who had reoperation for bleeding had longer hospital stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), but similar rates of RLN palsy, wound infection, and hypoparathyroidism.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A higher risk profile for significant post\u2010operative bleeding cannot be determined in patients undergoing thyroid surgery. Based on this experience, we developed protocols to reduce the risk of bleeding (the ITSRED Fred protocol) and for the early detection and management of bleed (the SCOOP protocol) following thyroid and\/or parathyroid surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-019-05322-2","type":"journal-article","created":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T12:05:42Z","timestamp":1575979542000},"page":"1156-1162","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management"],"prefix":"10.1002","volume":"44","author":[{"given":"O.","family":"Edafe","sequence":"first","affiliation":[{"name":"Department of ENT Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"},{"name":"Department of Oncology and Metabolism University of Sheffield Beech Hill Road S10 2RX Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Cochrane","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of General Surgery Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. P.","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of General Surgery Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"},{"name":"Department of Oncology and Metabolism University of Sheffield Beech Hill Road S10 2RX Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2007.12.008"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.1076"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2016.63004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7824"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.03.015"},{"key":"e_1_2_7_7_1","first-page":"A5016","article-title":"Routine outpatient thyroid surgery cannot be 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December 2019","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}