Analysis of preoperative influential factors and construction of a predictive nomogram of difficult thyroidectomy

Abstract Objective To explore the preoperative influential factors of difficult thyroidectomy and establish a preoperative nomogram for predicting the difficulty of thyroidectomy. Methods A total of 753 patients who underwent total thyroidectomy with central lymph node dissection between January 2018 and December 2021 were retrospectively enrolled in this study and randomly divided into training and validation groups at a ratio of 8:2. In both subgroups, the patients were divided into difficult thyroidectomy and nondifficult thyroidectomy groups based on the operation time. Patient age, sex, body mass index (BMI), thyroid ultrasound, thyroid function, preoperative fine needle aspiration (FNA), postoperative complications and other data were collected. Logistic regression analysis was performed to identify the predictors of difficult thyroidectomy, and a nomogram predicting surgical difficulty was created. Results Multivariate logistic regression analysis demonstrated that male sex (OR = 2.138, 95% CI 1.055–4.336, p = 0.035), age (OR = 0.954, 95% CI 0.932–0.976, p