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Analysis of the Risk Factors Associated with Prolonged Intubation or Reintubation after Anterior Cervical Spine Surgery
- Source :
- Journal of Korean Medical Science
- Publication Year :
- 2018
- Publisher :
- Korean Academy of Medical Sciences, 2018.
-
Abstract
- Background Standardized postoperative airway management is essential for patients undergoing anterior cervical spine surgery (ACSS). The paucity of clinical series evaluating these airway complications after ACSS has been resulted in a significant limitation in statistical analyses. Methods A retrospective cohort study was performed regarding airway distress (intubation for more than 24 hours or unplanned reintubation within 7 days of operation) developed after ACSS. If prevertebral soft tissue swelling was evident after the operation, patients were managed with prolonged intubation (longer than 24 hours). Preoperative and intraoperative patient data, and postoperative outcome (time to extubation and reintubation) were analyzed. Results Between 2008 and 2016, a total of 400 ACSS were performed. Of them, 389 patients (97.25%) extubated within 24 hours of surgery without airway complication, but 11 patients (2.75%) showed postoperative airway compromise; 7 patients (1.75%) needed prolonged intubation, while 4 patients (1.00%) required unplanned reintubation. The mean time for extubation were 2.75 hours (range: 0–23 hours) and 50.55 hours (range: 0–250 hours), respectively. Age (P = 0.015), diabetes mellitus (P = 0.003), operative time longer than 5 hours (P = 0.048), and estimated blood loss (EBL) greater than 300 mL (P = 0.042) were associated with prolonged intubation or reintubation. In prolonged intubation group, all patients showed no airway distress after extubation. Conclusion In ACSS, postoperative airway compromise is related to both patients and operative factors. We recommend a prolonged intubation for patients who are exposed to these risk factors to perform a safe and effective extubation.<br />Graphical Abstract
- Subjects :
- Male
Neurology & Neuroscience
medicine.medical_treatment
Prolonged intubation
Reintubation
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Extubation
Risk Factors
Diabetes mellitus
Intubation, Intratracheal
Humans
Medicine
Intubation
Postoperative Period
Airway Management
Aged
Retrospective Studies
Aged, 80 and over
030222 orthopedics
business.industry
Retrospective cohort study
General Medicine
Middle Aged
medicine.disease
Airway Compromise
Spinal Fusion
Anesthesia
Cervical Vertebrae
Original Article
Female
Airway management
Airway
business
Complication
Anterior Cervical Spine Surgery
030217 neurology & neurosurgery
Diskectomy
Subjects
Details
- ISSN :
- 15986357 and 10118934
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Journal of Korean Medical Science
- Accession number :
- edsair.doi.dedup.....fb8a30555c82c637e7acd7f857e9e7b0