What is Impact of Thyroid Function on Surgical Prognosis in Patients Undergoing Cardiac and Major Vascular Surgeries?

Cardiac and major vascular surgeries are intricate and high-risk procedures known for significant morbidity and mortality rates, despite advancements in surgical techniques and perioperative care. In recent years, there has been a growing interest in understanding the impact of thyroid dysfunction on surgical outcomes. Thyroid hormones play a crucial role in regulating various physiological processes essential for systemic homeostasis, metabolic rates, and cardiovascular function.

Correlation Between Thyroid Function and Surgical Outcomes

Recent retrospective cohort study by Sun et al. investigated the correlation between thyroid function and postoperative outcomes in 472 patients who underwent cardiac surgeries (coronary artery bypass grafting, aortic surgery, valve surgery, and primary cardiac neoplasms resection). They conducted preoperative and postoperative thyroid function tests, which revealed significant decreases in thyroid hormone levels (TSH, FT3, and FT4) postoperatively. The study utilized multivariate logistic regression models and restricted cubic splines to identify associations between thyroid function markers and outcomes such as total hospital stay, ICU stay, and duration of mechanical ventilation.

Association Between Thyroid Function Markers and Postoperative Outcomes

The results indicated that changes in TSH levels were significantly linked to various postoperative outcomes, including prolonged hospital stay and mechanical ventilation duration. Conversely, higher postoperative FT3 levels were associated with shorter hospital stays and reduced ICU requirements. While nonlinear relationships were not significant, the study highlighted tendencies between preoperative TSH levels and certain outcomes.

Importance of Monitoring Thyroid Function for Patient Recovery

The findings emphasize the importance of monitoring and managing thyroid function before and after surgery to enhance patient recovery. Previous studies have also highlighted the impact of thyroid function on cardiovascular outcomes and underscored the need for optimized thyroid function in improving postoperative prognosis.

Acknowledging Limitations and Proposing Future Research

The study acknowledges some limitations, such as its retrospective nature and potential confounding factors. Future research should aim to include larger and more diverse populations to validate and strengthen the findings. In conclusion, thyroid dysfunction appears to influence postoperative outcomes in patients undergoing cardiac and major vascular surgeries, suggesting the value of preoperative thyroid assessment and personalized management strategies for better surgical recovery.

Key Points

- Cardiac and major vascular surgeries have high morbidity and mortality rates despite advancements in care, prompting a focus on understanding the impact of thyroid dysfunction on surgical outcomes due to the crucial role of thyroid hormones in regulating physiological processes.

- A retrospective cohort study by Sun et al. explored the correlation between thyroid function and postoperative results in 472 patients who underwent cardiac surgeries, revealing significant decreases in thyroid hormone levels postoperatively and associations between thyroid function markers and outcomes like hospital stay, ICU duration, and mechanical ventilation.

- Changes in TSH levels postoperatively were significantly linked to outcomes such as prolonged hospital stays and mechanical ventilation duration, while higher postoperative FT3 levels correlated with shorter hospital stays and reduced ICU requirements, indicating the importance of monitoring and managing thyroid function for patient recovery.

- Although nonlinear relationships were not significant, there were tendencies noted between preoperative TSH levels and certain outcomes, reinforcing the need for optimized thyroid function to improve postoperative prognosis.

- The importance of monitoring and managing thyroid function before and after surgery is emphasized in enhancing patient recovery, supported by previous studies showcasing the impact of thyroid function on cardiovascular outcomes, highlighting the need for preoperative thyroid assessment and personalized management strategies.

- Acknowledging limitations like the study's retrospective nature and potential confounding factors, future research should involve larger and more diverse populations to validate and strengthen the findings, ultimately suggesting that thyroid dysfunction influences postoperative outcomes in patients undergoing cardiac and major vascular surgeries, advocating for tailored management approaches for improved surgical recovery.

Reference –

Sun, Q., Wang, W., Mao, X. et al. The impact of thyroid function on surgical prognosis in patients undergoing cardiac and major vascular surgeries. J Cardiothorac Surg 20, 152 (2025). https://doi.org/10.1186/s13019-025-03365-2