AI Article Synopsis
- Increased anesthesia time for tracheostomy patients was studied to see if it leads to respiratory complications like pneumonia and ventilator dependence.
- The analysis of 752 patients over seven years showed that prolonged anesthesia was not significantly linked to these complications, despite some patients experiencing post-operative issues.
- Key predictors for ventilator dependence included age, pre-existing respiratory issues, and sepsis, highlighting that faster anesthesia isn't necessarily better for patient outcomes.
Article Abstract
Background: Increased anesthesia time may lead to respiratory complications in patients receiving tracheostomy, which contributes to patient morbidity.
Methods: The American College of Surgeon's National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases of planned tracheostomy (CPT 31600) from 2005 to 2012. Patients were stratified into quintiles based on anesthesia duration. Pearson's chi square, Fischer's exact test, one-way ANOVA, and multivariate regression were used to determine the association between patient characteristics with pneumonia and ventilator dependence.
Results: Out of 752 patients, 83 patients experienced post-operative pneumonia, and 166 experienced ventilator dependence. Following multivariate regression analysis, anesthesia quintiles were not significantly associated with pneumonia or ventilator dependence. Age (OR 1.03, 95% CI 1.00-1.05, P = .032), dyspnea (OR 2.21, 95% CI 1.18-4.13; P = .013), pre-operative ventilator dependence (OR 3.08, 95% CI 1.19-7.98; P = .020), and sepsis (OR 6.68, 95% CI 3.19-14.0; P < .001) remained as significant predictors of post-operative ventilator dependence.
Conclusions: Faster may not be better-- prolonged anesthesia time does not increase the risk of post-operative pneumonia or ventilator dependence in patients receiving a planned tracheostomy in the operating room.
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| http://dx.doi.org/10.1016/j.amjsurg.2018.07.059 | DOI Listing |
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