The perils of poor postop blood pressure control
Reviewed by Andrew Hall

This retrospective case control study reviews 621 patients undergoing thyroid surgery over a 10-year period from 2002-2012 looking at postoperative haemorrhage rates. This potentially catastrophic complication warrants close analysis in order to best discern how it can be minimised. The benchmark incidence in high volume thyroid centres is 0.3-1%, while for this analysis the overall rate recorded was 2.57%. The principle independent risk factor for postoperative haemorrhage on the day of surgery after multivariate regression was found to be postoperative systolic blood pressure level. There was a 39% increase in risk of bleeding for every 10 point rise in systolic blood pressure over 170mmHg. (Odds ratio: 1.39; 95% CI= 1.09-1.8.) Regular blood pressure review and decisive action to control the systolic blood pressure in the early postoperative period would appear a wise recommendation. The authors do not presently suggest the best means of policing this parameter but this is an area of attention needing to be highlighted to nursing staff and junior surgeons alike.

Postoperative systolic blood pressure as a risk factor for haematoma following thyroid surgery.
Morton RP, Vandal AC.
CLINICAL OTOLARYNGOLOGY
2015;40:462-7.