Multivariate analysis of airway obstruction and reintubation after anterior cervical surgery: A Retrospective Cohort Study of 774 patients

Li, Haoxi; Huang, Yu‐Feng; Shen, Bin; Ba, Zhaoyu; Wu, Desheng

doi:10.1016/j.ijsu.2017.03.014

Cited by 20 publications

(29 citation statements)

References 15 publications

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“…Additionally, pneumonia is the fourth most common cause of mortality in the elderly in Japan 16) . Numerous studies have tried to clarify the risk factors linked to PRC, such as postoperative airway obstruction and pneumonia, older age, male gender, smoking, obesity, chronic obstructive pulmonary disease, bleeding disorders, an increased number of fused vertebral levels, blood loss, and prolonged operative durations 6,9,[19][20] . However, the number of patients who experience severe PRC after ADF has not decreased.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, postoperative respiratory complications (PRC) can cause serious problems and major issues after ADF. Past reports indicate that postoperative adverse events of a respiratory nature, such as pneumonia and airway obstruction, occur in 0.6%-14% of patients after ADF [6][7][8]9) . Sometimes, accidental airway obstruction becomes a potentially life-threatening event that may require reintubation, for which one must be prepared with an effective management plan.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors and Assessment Using an Endoscopic Scoring System for Postoperative Respiratory Complications after Anterior Cervical Decompression and Fusion Surgery

Ohba

Akaike

Fujita

et al. 2021

Spine Surg Relat Res

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Introduction: Postoperative respiratory complications (PRC) are one of the most serious complications. Potentially life-threatening accidents can occur after an anterior cervical discectomy and fusion (ADF), such as airway obstruction and aspiration pneumonia. Despite numerous studies, preoperative predictive and preventive methodology has yet to be established. As reported in our previous study, the evaluation of preoperative dysphagia using the eating assessment tool (EAT-10) and a flexible endoscopic evaluation of swallowing (FEES) is useful for predicting the incidence and risk factors of dysphagia after ADF. Methods: This prospective study comprised 60 consecutive patients who underwent ADF. An otolaryngologist and a speech-language-hearing therapist preoperatively and 1 week postoperatively evaluated dysphagia using EAT-10 and Hyodo-Komagane (H-K) scores during FEES. Patient demographics, comorbidities, and pre-and postoperative dysphagia were compared between patients with and without PRC. Results: Seven of 60 (11.6%) patients had preoperative dysphagia diagnosed using the H-K score. A significant positive correlation existed between the pre-and postoperative H-K scores. Of all 60 cases, eight (13.3%) had PRC. Among them, two required reintubation due to airway obstruction and six had aspiration pneumonia. The PRC(+) group was significantly older and more prone to diabetes and asthma. The preoperative H-K score of the PRC(+) group was significantly higher than that of the PRC(−) group. Postoperatively, but not preoperatively, EAT-10 was significantly higher in the PRC(+) group. Conclusions: Preoperative dysphagia may potentially exacerbate postoperative dysphagia after ADF. A preoperative evaluation of dysphagia using the H-K score during FEES is a useful method for predicting and reducing the risk of PRC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factors and Assessment Using an Endoscopic Scoring System for Postoperative Respiratory Complications after Anterior Cervical Decompression and Fusion Surgery

Ohba

Akaike

Fujita

et al. 2021

Spine Surg Relat Res

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“…In contrast, the present study, considered EF as the requirement for reintubation after more than 48 hours. In previous studies, EF rates have varied between 1.81% and 19% 3,13,17 ; these values differ according to the population studied and the time of OI. In the study by Santos et al 3 , the authors investigated a heterogeneous cancer population and found high EF values (17.5%); these results that differ from the present study, in which occurred in only 3.6% of patients, even though the population was similar.…”

Section: Discussionmentioning

confidence: 97%

“…In addition, patients who smoked were predominant at 71.42% 17 . In our study, 53.8% of the patients were smokers or ex-smokers, and 84.6% had altered mental status occurred while in the ICU.…”

Section: Discussionmentioning

confidence: 99%

“…Retrospective studies [15][16][17] have evaluated different populations presenting with EF, dividing them into two groups: patients successfully extubated and those who presented EF. In a study by Li et al 17 , the studied population was reintubated because of airway obstruction after previous cervical surgery. Nantsupawat et al 16 studied patients with chronic obstructive disease (COPD) who were reintubated due to respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

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Falência da extubação orotraqueal em uma amostra de pacientes oncológicos

Agu

Caruso

Oliveira

et al. 2020

Rev. Med. (São Paulo)

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Objetivo: Classificar a taxa de falha de extubação orotraqueal (FE) em uma amostra de pacientes oncológicos e avaliar a associação entre FE, índice de mortalidade e eventos clínicos. Métodos: Estudo descritivo, retrospectivo, para coleta de dados do prontuário no período de março de 2012 a maio de 2017 envolvendo 1.088 prontuários que necessitaram suporte ventilatório invasivo durante a internação na UTI. Resultados: 39 pacientes necessitaram de reintubação precoce durante a estadia em UTI, no qual a taxa de incidência de FE foi de 3,6%, média de idade de 59,6 anos com predomínio do sexo masculino, com uma alta incidência de complicações respiratórias e pneumonia. O tempo médio de reintubação após a extubação foi de 16,5 ± 14,0 h, tendo como principal motivo da reintubação fadiga respiratória (48,7%) e o principal desfecho foi óbito (56,4%). Foram elaborados três modelos de regressão univariada e multivariada para o tempo de reintubação, dias de internação na UTI (R2: 61,7%) e o óbito (R2: 78,8) que demonstrou variáveis independentes capazes de predizer a mudança nos modelos estudados. O modelo que melhor respondeu à nossa meta foi óbito com variância explicada de 78,8%. Conclusão: Nossos achados demonstraram uma baixa incidência da falência na extubação e a importância da identificação de fatores de risco específicos para a população oncológica, predizendo que tais fatores poderiam influenciar a necessidade de reintubação.

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ICU Care for the Spine Patient

Romito

2022

Multidisciplinary Spine Care

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Multivariate analysis of airway obstruction and reintubation after anterior cervical surgery: A Retrospective Cohort Study of 774 patients

Cited by 20 publications

References 15 publications

Risk Factors and Assessment Using an Endoscopic Scoring System for Postoperative Respiratory Complications after Anterior Cervical Decompression and Fusion Surgery

Risk Factors and Assessment Using an Endoscopic Scoring System for Postoperative Respiratory Complications after Anterior Cervical Decompression and Fusion Surgery

Falência da extubação orotraqueal em uma amostra de pacientes oncológicos

ICU Care for the Spine Patient

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