Abstract
Background: The benefit of drains remains unclear and variable among thyroid surgeons. This study examines the utility and trend in drain use after thyroidectomy. Method: This is a retrospective cross-sectional study utilizing a pooled sample of thyroidectomy patients from the 2016-2019 NSQIP. The impact of drain use on outcomes of interest (rate of postoperative neck hematoma (PNH)- primary outcome, and length-of-stay (LOS)-secondary outcome), as well as year-over-year and practice variations were evaluated using inverse-probability-weighted-regression adjustment and multivariable logistic regression analyses. Results: Of 24,370 patients, 6673(27.4 %) received drains. The average LOS and PNH rates were 27.3 h and 1.87%, respectively. Drain use increased year-over-year for concomitant neck dissections (OR = 1.08,p = 0.002). Year-over-year odds of drain use trended down across specialties (OR = 0.96,p = 0.005); however, ENT used drains more frequently than General Surgeons (RR = 3.06, 95%CI = 2.91-3.22). Drains were associated with longer LOS (mean-difference = 9.6hrs, 95%CI 8.51-10.62) with no effect on PNH rates (RR = 0.96,p < 0.05). Conclusion: Drain use is decreasing, but practice variations across specialties persist. Post-thyroidectomy drain use was associated with longer LOS with no effect on PNHR.