| Title |
Hypothyroidism and Wound Healing After Salvage Laryngectomy
|
|---|---|
| Published in |
Annals of Surgical Oncology, December 2017
|
| DOI | 10.1245/s10434-017-6278-4 |
| Pubmed ID | |
| Authors |
Andrew J. Rosko, Andrew C. Birkeland, Emily Bellile, Kevin J. Kovatch, Ashley L. Miller, Craig C. Jaffe, Andrew G. Shuman, Steven B. Chinn, Chaz L. Stucken, Kelly M. Malloy, Jeffrey S. Moyer, Keith A. Casper, Mark E. P. Prince, Carol R. Bradford, Gregory T. Wolf, Douglas B. Chepeha, Matthew E. Spector |
| Abstract |
Patients undergoing salvage laryngectomy are predisposed to radiation-induced hypothyroidism and impaired wound healing secondary to the tissue effects of prior treatment. The impact of hypothyroidism on postoperative wound healing is not established. A single-institution retrospective case series was performed. The inclusion criteria specified preoperatively euthyroid adults who underwent salvage laryngectomy with concurrent neck dissection between 1997 and 2015 for persistent or recurrent laryngeal squamous cell carcinoma after radiation or chemoradiation therapy (n = 182). The principal explanatory variable was postoperative hypothyroidism, defined as thyroid-stimulating hormone (TSH) higher than 5.5 mIU/L. The primary end points of the study were pharyngocutaneous fistulas and wounds requiring reoperation. Multivariate analysis was performed. The fistula rate was 47% among hypothyroid patients versus 23% among euthyroid patients. In the multivariate analysis, the patients who experienced hypothyroidism in the postoperative period had a 3.6-fold greater risk of fistula [95% confidence interval (CI) 1.8-7.1; p = 0.0002]. The hypothyroid patients had an 11.4-fold greater risk for a required reoperation (24.4 vs 5.4%) than the euthyroid patients (95% CI 2.6-49.9; p = 0.001). The risk for fistula (p = 0.003) and reoperation (p = 0.001) increased with increasing TSH. This corresponds to an approximate 12.5% incremental increase in the absolute risk for fistula and a 10% increase in the absolute risk for reoperation with each doubling of the TSH. Postoperative hypothyroidism independently predicts postoperative wound-healing complications. The association of hypothyroidism with fistula formation may yield opportunities to modulate wound healing with thyroid supplementation or to provide a biomarker of wound progression. |
X Demographics
The data shown below were collected from the profiles of 5 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Italy | 1 | 20% |
| United States | 1 | 20% |
| Unknown | 3 | 60% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 80% |
| Scientists | 1 | 20% |
Mendeley readers
The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 35 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 4 | 11% |
| Researcher | 3 | 9% |
| Student > Doctoral Student | 3 | 9% |
| Unspecified | 1 | 3% |
| Student > Bachelor | 1 | 3% |
| Other | 6 | 17% |
| Unknown | 17 | 49% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 40% |
| Psychology | 2 | 6% |
| Neuroscience | 1 | 3% |
| Unspecified | 1 | 3% |
| Unknown | 17 | 49% |
Attention Score in Context
This research output has an Altmetric Attention Score of 42. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 May 2018.
All research outputs
#861,535
of 23,337,345 outputs
Outputs from Annals of Surgical Oncology
#85
of 6,619 outputs
Outputs of similar age
#21,488
of 442,421 outputs
Outputs of similar age from Annals of Surgical Oncology
#6
of 88 outputs
Altmetric has tracked 23,337,345 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,619 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.4. This one has done particularly well, scoring higher than 98% of its peers.
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We're also able to compare this research output to 88 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.