BACKGROUND: We tested the hypothesis that @entity1375 , as defined by thyroid-stimulating hormone (TSH) concentration, is associated with a severity-weighted composite of mortality and major @entity65 after noncardiac surgery. METHODS: In this retrospective cohort study, we evaluated adults at the Cleveland Clinic Main Campus between 2005 and 2012, who had had available TSH concentrations within the 6 months before noncardiac surgery. @entity1 were categorized as (1) @entity1375 ( @entity1 who had diagnosis of @entity1375 any time prior to surgery and increased TSH value (> 5.5 mIU/L) within 6 months prior to surgery); (2) treated ( @entity1375 diagnosis and normal TSH concentrations [0.4-5.5 mIU/L]); and (3) euthyroid (no @entity1375 diagnosis and normal TSH concentrations). We conducted pairwise comparisons among the 3 groups using inverse propensity score weighting to control for observed confounding variables. Average relative effect generalized estimating equation model was used for the primary outcome composite of in-hospital @entity65 , surgical wound complication or @entity281 , and mortality. Logistic regression and Cox proportional hazards regression were used for secondary outcomes of intraoperative vasopressor use and duration of hospitalization, respectively. RESULTS: We identified 800 @entity1375 @entity1 (median TSH: 8.6 mIU/L [Q1, Q3: 6.5, 13.0]), 1805 treated @entity1 (2.0 mIU/L [1.1, 3.2]), and 5612 euthyroid @entity1 (1.7 mIU/L [1.1, 2.6]). There were no significant differences among the @entity1375 , treated, and euthyroid @entity1 on the primary composite outcome (all P values >= 0.30). @entity1375 @entity1 were slightly more likely to receive vasopressor during surgery than either treated (odds ratio, 1.17; 99.2% confidence interval [CI], 1.01-1.36) or euthyroid (odds ratio, 1.12; 99.2% CI, 1.02-1.24) @entity1 . Furthermore, @entity1375 @entity1 were slightly but significantly less likely to be discharged at any given postoperative time than treated @entity1 (hazard ratio, 0.92; 99.2% CI, 0.86-0.99). CONCLUSIONS: @entity1375 was not associated with worse postoperative mortality, wound, or cardiovascular outcomes in noncardiac @entity1 . Thus, postponing surgery to initiate thyroid replacement therapy in @entity1 with @entity1375 seems unnecessary.

The Effect of XXXX on a Composite of Mortality, @entity65 After Noncardiac Surgery: A Retrospective Cohort Analysis.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1375 :: ('MESH:D007037', 'Disease') :: ['Hypothyroidism', 'Hypothyroid', 'hypothyroidism', 'hypothyroid'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular and infectious complications', 'cardiovascular morbidity'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection']
@entity1375 :: (MESH:D007037,Disease) :: ['Hypothyroidism']
