Highlights
- •This study identified the incidence of prolonged ventilation and reintubation after adult spinal deformity surgery at 2.7% and 1.8%, respectively.
- •Factors associated with prolonged ventilation included bleeding disorder and operative time over 6 h.
- •Factors associated with reintubation included older age, history of bleeding disorder, and fusion of 13 or more spinal segments.
Abstract
Prolonged ventilation or reintubation are severe complications after scoliosis surgery,
but there is limited data regarding their incidence and risk factors. The purpose
of this study is to investigate the incidence and risk factors for prolonged ventilation
and reintubation in adult spinal deformity (ASD) surgery. The American College of
Surgeons National Surgical Quality Improvement Program database (2007–2013) was reviewed.
Inclusion criteria were adult patients over 21 years of age who underwent spinal fusion for ASD. The association between patient/operative
characteristics and prolonged ventilation/reintubation was investigated via multivariate
analysis. Results are presented as odds ratios (OR) with 95% confidence intervals
(CI). There were 1250 patients who underwent ASD surgery and met our inclusion criteria.
Among these, there were 34 patients who required prolonged ventilation (2.7%) and
22 patients who underwent reintubation (1.8%). Factors associated with prolonged ventilation
after multivariate analysis were history of bleeding disorder (OR 5.67; 95% CI, 1.01–31.83)
and operative time over 6 h (OR 3.72; 95% CI, 1.17–11.80). For reintubation, these included older age (OR 1.06;
95% CI, 1.01–1.12), history of bleeding disorder (OR 12.21; 95% CI, 2.03–73.42), and
fusion of 13 or more spinal levels (OR 9.14; 95% CI, 1.53–54.63). In conclusion, prolonged
ventilation and reintubation in ASD surgery are uncommon events. Older patients, patients
with bleeding disorders, and those undergoing long operations and fusion of 13 more
spinal segments may be at an increased risk for these occurrences.
Keywords
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Article info
Publication history
Published online: May 24, 2017
Accepted:
April 22,
2017
Received:
January 30,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
