Dependent functional status is associated with unplanned postoperative intubation after elective cervical spine surgery: a national registry analysis

Purpose The impact of preoperative functional status on 30-day unplanned postoperative intubation and clinical outcomes among patients who underwent cervical spine surgery is not well-described. We hypothesized that functional dependence is associated with 30-day unplanned postoperative intubation a...

Full description

Saved in:
Bibliographic Details
Published in:Journal of anesthesia 2018-08, Vol.32 (4), p.565-575
Main Authors: Burton, Brittany N., Lin, Timothy C., A’Court, Alison M., Schmidt, Ulrich H., Gabriel, Rodney A.
Format: Article
Language:English
Subjects:
Anesthesiology
Critical Care Medicine
Emergency Medicine
Intensive
Medicine
Medicine & Public Health
Original Article
Pain Medicine
Patient outcomes
Physiological aspects
Postoperative care
Spinal surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose The impact of preoperative functional status on 30-day unplanned postoperative intubation and clinical outcomes among patients who underwent cervical spine surgery is not well-described. We hypothesized that functional dependence is associated with 30-day unplanned postoperative intubation and that among the reintubated cohort, functional dependence is associated with adverse postoperative clinical outcomes after cervical spine surgery. Methods Utilizing the 2007–2016 American College of Surgeons National Surgical Quality Improvement Program database, we identified adult elective anterior and posterior cervical spine surgery patients by Current Procedural Terminology codes. We performed (1) a Cox Proportional Hazard analysis for the following outcomes: reintubation, prolonged ventilator use, and pneumonia and (2) an adjusted logistic regression analysis among patients that required postoperative reintubation to evaluate the association of functional status with adverse postoperative outcomes. Results The sample size was 26,263, of which 550 (2.1%) were functionally dependent. The adjusted model suggested that when compared with functionally independent patients, dependent patients were at increased risk of unplanned 30-day intubation (HR 2.05, 95% CI 1.26–3.34; P  = 0.003). The adjusted risk of 30-day postoperative pneumonia was significantly higher in patients with functional dependence (HR 1.61, 95% CI 1.02–2.54, P  = 0.036). Among patients that required postoperative reintubation, the odds of 30-day mortality was significantly higher in patients with functional dependence (OR 5.82, 95% CI 1.59–23.4, P  
ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-018-2515-7