Association of Case Management Nursing with Swallowing and Voice Recovery and Quality of Life After Transoral Thyroidectomy: A Retrospective Study with Predictive Modeling
- 1Department of Breast and Thyroid Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421002, People’s Republic of China
- 2Department of Operating Room, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421002, People’s Republic of China
Abstract
Aim: To investigate the association of case management nursing (CMN) with swallowing and voice function recovery and quality of life (QOL) improvement after transoral thyroidectomy, and to develop a predictive model for favorable comprehensive postoperative recovery.
Methods: This retrospective study included 256 patients undergoing transoral thyroidectomy (CMN group, n = 128; control group, n = 128). The 10-item Eating Assessment Tool (EAT-10), 10-item Voice Handicap Index (VHI-10), and 36-item Short Form Health Survey (SF-36) scores were compared. Linear mixed-effects models were constructed to analyze time effects and group × time interactions on functional recovery. Logistic regression was used to identify factors associated with favorable comprehensive recovery at 3 months. Model discrimination and calibration were evaluated. Internal validation was performed using 1000 bootstrap resamples.
Results: EAT-10 and VHI-10 scores peaked at 24 hours post-surgery in both groups, then gradually declined. Linear mixed-effects models showed significant time effects (all P < 0.05) and significant CMN × time interactions. At 3 months, the CMN group had significantly higher SF-36 scores (P < 0.001) and greater ΔSF-36 (P < 0.001) versus controls. Multivariable logistic regression identified CMN as an independent factor associated with favorable recovery (OR = 14.816, 95% CI: 6.563–36.813, P < 0.001). The prediction model showed an apparent AUC of 0.794 (95% CI: 0.737–0.850), which decreased to an optimism-corrected AUC of 0.776 after 1000 bootstrap resamples. The optimism-corrected Brier score, calibration intercept, and calibration slope were 0.164, −0.003, and 0.921, respectively.
Conclusion: CMN was associated with better swallowing and voice recovery and improved QOL after transoral thyroidectomy. The prediction model showed acceptable internal performance but requires external validation before clinical application.
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BibTeX
@article{zhou2026association,
title = {{Association of Case Management Nursing with Swallowing and Voice Recovery and Quality of Life After Transoral Thyroidectomy: A Retrospective Study with Predictive Modeling}},
author = {Yingping Zhou and Zhongjun Jiang and Caiyun Wu},
journal = {Journal of Multidisciplinary Healthcare},
year = {2026},
month = nov,
doi = {10.2147/jmdh.s633053},
url = {https://doi.org/10.2147/jmdh.s633053},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Association of Case Management Nursing with Swallowing and Voice Recovery and Quality of Life After Transoral Thyroidectomy: A Retrospective Study with Predictive Modeling
AU - Yingping Zhou
AU - Zhongjun Jiang
AU - Caiyun Wu
PY - 2026
DA - 2026/11/01
JO - Journal of Multidisciplinary Healthcare
DO - 10.2147/jmdh.s633053
UR - https://doi.org/10.2147/jmdh.s633053
AB - Aim: To investigate the association of case management nursing (CMN) with swallowing and voice function recovery and quality of life (QOL) improvement after transoral thyroidectomy, and to develop a predictive model for favorable comprehensive postoperative recovery. Methods: This retrospective study included 256 patients undergoing transoral thyroidectomy (CMN group, n = 128; control group, n = 128). The 10-item Eating Assessment Tool (EAT-10), 10-item Voice Handicap Index (VHI-10), and 36-item Short Form Health Survey (SF-36) scores were compared. Linear mixed-effects models were constructed to analyze time effects and group × time interactions on functional recovery. Logistic regression was used to identify factors associated with favorable comprehensive recovery at 3 months. Model discrimination and calibration were evaluated. Internal validation was performed using 1000 bootstrap resamples. Results: EAT-10 and VHI-10 scores peaked at 24 hours post-surgery in both groups, then gradually declined. Linear mixed-effects models showed significant time effects (all P < 0.05) and significant CMN × time interactions. At 3 months, the CMN group had significantly higher SF-36 scores (P < 0.001) and greater ΔSF-36 (P < 0.001) versus controls. Multivariable logistic regression identified CMN as an independent factor associated with favorable recovery (OR = 14.816, 95% CI: 6.563–36.813, P < 0.001). The prediction model showed an apparent AUC of 0.794 (95% CI: 0.737–0.850), which decreased to an optimism-corrected AUC of 0.776 after 1000 bootstrap resamples. The optimism-corrected Brier score, calibration intercept, and calibration slope were 0.164, −0.003, and 0.921, respectively. Conclusion: CMN was associated with better swallowing and voice recovery and improved QOL after transoral thyroidectomy. The prediction model showed acceptable internal performance but requires external validation before clinical application.
SN - 1178-2390
ER -