Clinical audit of the presentation and outcome of benign thyroid disorders in a tertiary care setting in Pakistan

Objective: To assess the clinical presentation and outcome of surgical management of benign thyroid disorders in a tertiary care set up in Pakistan. Methods: The clinical audit was carried out at the Department of Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2002 to December 2010. The data were recorded on a pre-designed proforma, which comprehensively encompassed the relevant variables and outcome measures. SPSS 10 was used for statistical analysis. Results: Out of 527 patients, there were 474(89.94%) females and 53(10.05%) males. The overall age ranged 21-56 years, with a mean of 41.99 +/- 9.07 years. Symptoms due to local pressure effects of the goiter were the commonest presenting features found in 473(89.75%) patients. The mean duration of thyroid disorder was 11.85 +/- 3.41 years. Hypothroidism was the commonest biochemical abnormality found in 117(22.20%) patients, while hyperthyroidism was found in 63(11.95%) patients. Multinodular goitre was the most frequent disorder found in 439(83.30%) patients. Subtotal thyroidectomy constituted the commonest surgical procedure performed in 398(75.52%) patients. Temporary hypocalcaemia was the most common post-operative complication observed in 93(17.64%) patients. The mean hospital stay was 4.76 +/- 2.14days. There was no in-hospital mortality. Conclusion: Benign thyroid disorders are prevalent in our population and commonly affect the younger females. Majority of the patients have a family history of thyroid disorders. Most of the patients present with several years history of the disease. Subtotal thyroidectomy is the most frequently offered surgical procedure, which is safe.