(A585) Non-tobacco Nicotine Dependent Patients and Post-operative Complications Following Thyroidectomy

Introduction: For years, studies have shown that tobacco product usage increases the risk of post-operative complications and overall morbidity. Because of this, non-tobacco nicotine products have become increasingly popular and are believed to be a safer alternative to traditional tobacco products such as cigarettes. Our study aims to evaluate common post-operative complications following thyroidectomy in non-tobacco nicotine product users.

Methods: Using the TriNetX database, we compared two cohorts: patients greater than or equal to age 18 with non-tobacco nicotine dependence who had undergone partial or total thyroidectomy for non-malignant reasons between 2013 and 2023 (cohort 1), and those of the same criteria, but without nicotine dependence (cohort 2). Cohorts were then propensity matched for demographics and controlled for health conditions that may affect outcomes. Outcomes and complications were examined from 1 day to 6 months post-operatively and include hypoparathyroidism, infection following procedure, thyrotoxicosis, hypocalcemia, dysphonia, laryngospasm, and mortality.

Results: Cohort 1 was less likely to experience hypoparathyroidism up to 6 months post-operatively compared to cohort 2 (p < 0.05, RR 0.577) but more likely to experience infection (p < 0.05, RR 2.265) and laryngospasm (p < 0.005) following surgery. Although not statistically significant, cohort 1 was more likely to experience mortality within the 6 month post operative period (p = 0.06, RR 2.008). There was no significant difference between cohorts when examining risk for thyrotoxicosis (p = 0.41, RR 1.415), hypocalcemia (p = 0.25, RR 0.875), or dysphonia (p = 0.58, RR 0.901).

Conclusions: Although non-tobacco nicotine products may be an overall safer alternative, they do not come without risks, especially when concerning recovery from head and neck operations and potential complications. Our study supports the need for further investigation of post-operative complications in non-tobacco nicotine product users and updated cessation guidelines for patients.