Risk Factors Associated With Early Postoperative Respiratory Failure: A Matched Case-Control Study
| Autor: | Michael A. Gropper, Christiana Drake, Patrick S Romano, Michael K. Ong, J. Matthew Aldrich, Maxime Cannesson, Alpesh Amin, Laura N. Godat, Garth H. Utter, Rebecca A. Marmor, Jacqueline C. Stocking |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Operative Time Comorbidity Article California Positive-Pressure Respiration 03 medical and health sciences Postoperative Complications 0302 clinical medicine epidemiology [California] Risk Factors Interquartile range Internal medicine Tidal Volume medicine Humans Elective surgery epidemiology [Postoperative Complications] Tidal volume Aged Intraoperative Care epidemiology [Respiratory Insufficiency] business.industry Respiration Incidence (epidemiology) Case-control study Odds ratio Middle Aged Respiration Artificial Confidence interval Respiratory failure Case-Control Studies 030220 oncology & carcinogenesis Artificial Female 030211 gastroenterology & hepatology Surgery Analgesia Respiratory Insufficiency business |
| Zdroj: | J Surg Res |
| ISSN: | 0022-4804 |
| Popis: | Background Postoperative respiratory failure is the most common serious postoperative pulmonary complication, yet little is known about factors that can reduce its incidence. We sought to elucidate modifiable factors associated with respiratory failure that developed within the first 5 d after an elective operation. Materials and Methods Matched case-control study of adults who had an operation at five academic medical centers between October 1, 2012 and September 30, 2015. Cases were identified using administrative data and confirmed via chart review by critical care clinicians. Controls were matched 1:1 to cases based on hospital, age, and surgical procedure. Results Our total sample (n = 638) was 56.4% female, 71.3% white, and had a median age of 62 y (interquartile range 51, 70). Factors associated with early postoperative respiratory failure included male gender (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.12-2.63), American Society of Anesthesiologists class III or greater (OR 2.85, 95% CI 1.74-4.66), greater number of preexisting comorbidities (OR 1.14, 95% CI 1.004-1.30), increased operative duration (OR 1.14, 95% CI 1.06-1.22), increased intraoperative positive end-expiratory pressure (OR 1.23, 95% CI 1.13-1.35) and tidal volume (OR 1.13, 95% CI 1.004-1.27), and greater net fluid balance at 24 h (OR 1.17, 95% CI 1.07-1.28). Conclusions We found greater intraoperative ventilator volume and pressure and 24-h fluid balance to be potentially modifiable factors associated with developing early postoperative respiratory failure. Further studies are warranted to independently verify these risk factors, explore their role in development of early postoperative respiratory failure, and potentially evaluate targeted interventions. |
| Databáze: | OpenAIRE |
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