Quality of life after thyroid surgery: A prospective cohort study with a 12-month follow-up period
Juha Honkanen, Krisztina Molnár, Abdulmatin Moradi, Tuomo Karhumaa, Sanna Kakko, Petri Koivunen, Hanna Franssila, Merja Vakkala, Timo Kaakinen, Janne LiisananttiBackground:
A substantial number of thyroid surgeries are performed annually, and most patients are of working age. Research on the impact of thyroid surgery on patient quality of life (QoL) remains limited. This study evaluated changes in QoL within 1 year after thyroid surgery and identified risk factors for poor postoperative QoL. The prevalence of depressive symptoms and their association with QoL outcomes were examined.
Methods:
A prospective cohort study including all consecutive patients (n = 314) who underwent lobectomy or total thyroidectomy at Oulu University Hospital in Finland between September 2021 and December 2022. QoL was assessed using the RAND-36 questionnaire, and depressive symptoms were measured with the Beck Depression Inventory (BDI) before surgery and at 6 and 12 months postoperatively. Poor QoL was defined as a RAND-36 score more than two standard deviations below the age-adjusted population mean.
Results:
Overall QoL improved, particularly in mental well-being, but remained below the Finnish population norms across all domains in patients with complete QoL data across all time points (n = 143). Preoperative depressive symptoms were present in 42% of patients who completed the baseline BDI questionnaire (n = 162). Among these patients, QoL improved in the same domains but remained below the baseline level of the overall cohort. At 12 months (n = 157), 64% of patients had good QoL and 36% had poor QoL. In multivariable analysis, female gender, poor baseline QoL, and preoperative depressive symptoms independently predicted poor QoL at 12 months.
Conclusion:
Thyroid surgery improves QoL over 12 months, especially in mental health, but remains below the general population. Depressive symptoms are common and predict worse recovery, indicating that patients may benefit from preoperative psychological assessment and support.
Clinical trial registration
N/A.