Risk factors for unplanned reintubation caused by acute airway compromise after general anesthesia: a case-control study.
Airway
Complications
Extubation
General anesthesia
Prognosis
Journal
BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535
Informations de publication
Date de publication:
12 01 2021
12 01 2021
Historique:
received:
28
07
2020
accepted:
05
01
2021
entrez:
13
1
2021
pubmed:
14
1
2021
medline:
15
12
2021
Statut:
epublish
Résumé
This study aimed to identify the risk factors and evaluate the prognosis of unplanned reintubation caused by acute airway compromise (AAC) after general anesthesia. This case-control study included surgical patients who underwent unplanned reintubation in the operating room and postanesthesia care unit after general anesthesia between January 1, 2014, and December 31, 2018. Cases due to AAC were matched 1:4 with randomly selected controls. A total of 123,068 patients were included, and reintubation due to AAC was performed in 36 patients (approximate incidence 0.03%). Univariable analysis revealed that male sex, age > 65, ASA physical status 3, sepsis, heart disease history, cerebral infarction history, Cormack Lehane grade, surgery type, fresh frozen plasma infusion, increased intubation duration, white blood cell count, and creatinine clearance rate were related to AAC-caused unplanned reintubation. Multivariable analysis revealed that age > 65 (OR = 7.50, 95% CI 2.47-22.81, P < 0.001), ASA physical status 3 (OR = 6.51, 95% CI 1.18-35.92, P = 0.032), head-neck surgery (OR = 4.94, 95% CI 1.33-18.36, P = 0.017) or thoracic surgery (OR = 12.56, 95% CI 2.93-53.90, P < 0.001) and a high fluid load (OR = 3.04, 95% CI 1.16-7.99, P = 0.024) were associated with AAC-caused unplanned reintubation. AAC-caused unplanned reintubation patients had longer postoperative hospital (OR = 5.26, 95% CI 1.57-8.95, P < 0.001) and intensive care unit days (OR = 3.94, 95% CI 1.69-6.18, P < 0.001). Age > 65, ASA physical status 3, head-neck or thoracic surgery and high fluid load were found to be associated with AAC-caused unplanned reintubation.
Sections du résumé
BACKGROUND
This study aimed to identify the risk factors and evaluate the prognosis of unplanned reintubation caused by acute airway compromise (AAC) after general anesthesia.
METHODS
This case-control study included surgical patients who underwent unplanned reintubation in the operating room and postanesthesia care unit after general anesthesia between January 1, 2014, and December 31, 2018. Cases due to AAC were matched 1:4 with randomly selected controls.
RESULTS
A total of 123,068 patients were included, and reintubation due to AAC was performed in 36 patients (approximate incidence 0.03%). Univariable analysis revealed that male sex, age > 65, ASA physical status 3, sepsis, heart disease history, cerebral infarction history, Cormack Lehane grade, surgery type, fresh frozen plasma infusion, increased intubation duration, white blood cell count, and creatinine clearance rate were related to AAC-caused unplanned reintubation. Multivariable analysis revealed that age > 65 (OR = 7.50, 95% CI 2.47-22.81, P < 0.001), ASA physical status 3 (OR = 6.51, 95% CI 1.18-35.92, P = 0.032), head-neck surgery (OR = 4.94, 95% CI 1.33-18.36, P = 0.017) or thoracic surgery (OR = 12.56, 95% CI 2.93-53.90, P < 0.001) and a high fluid load (OR = 3.04, 95% CI 1.16-7.99, P = 0.024) were associated with AAC-caused unplanned reintubation. AAC-caused unplanned reintubation patients had longer postoperative hospital (OR = 5.26, 95% CI 1.57-8.95, P < 0.001) and intensive care unit days (OR = 3.94, 95% CI 1.69-6.18, P < 0.001).
CONCLUSIONS
Age > 65, ASA physical status 3, head-neck or thoracic surgery and high fluid load were found to be associated with AAC-caused unplanned reintubation.
Identifiants
pubmed: 33435881
doi: 10.1186/s12871-021-01238-4
pii: 10.1186/s12871-021-01238-4
pmc: PMC7802267
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
17Subventions
Organisme : Chinese Academy of Medical Sciences
ID : 2016-I2M-3-024
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