Risk factors for reintubation in the post-anaesthetic care unit: a case-control study.
BACKGROUND
Risk factors for reintubation in post-anaesthetic care units related to anaesthetic processes have not previously been reported. Our goal was to identify risk factors for reintubation in general surgical patients.


METHODS
A time-matched, case-control study was conducted on anaesthetic patients between 2001 and 2011. One hundred and sixty-four reintubated patients were compared with 656 randomly selected controls.


RESULTS
Independent risk factors for reintubation were age <1 yr vs age 30-49 yr [odds ratio (OR)=16.4, 95% confidence interval (CI)=5.7-47.7], chronic pulmonary disease (OR=2.1, CI=1.1-4.0), preoperative hypoalbuminaemia (OR=4.9, CI=2.4-10), creatinine clearance <24 vs >60 (OR=4.1, CI=1.2-13.4), emergency case (OR=1.8, CI=1.0-3.1), operative time >3 vs <1 h (OR=3.0, CI=1.5-6.2), airway surgery (OR=32.2, CI=13.6-76), head and neck surgery (OR=3.4, CI=1.8-6.2), cardiac surgery (OR=3.8, CI=1.1-13.4), thoracic surgery (OR=6.3, CI=1.9-21.2), cardiac catheterization (OR=2.5, CI=1.1-5.5), ASA physical status III (OR=3.8, CI=1.4-10), and the use of certain types of neuromuscular blocking agent (P<0.001).


CONCLUSIONS
Age <1 yr, chronic pulmonary disease, preoperative hypoalbuminaemia, and renal insufficiency were patient factors for reintubation. Emergency case, head and neck, cardiothoracic and airway surgery, and operative time >3 h were operative factors, while certain neuromuscular blocking agents and ASA physical status III were anaesthetic factors for reintubation.
Department of Anaesthesiology, Prince of Songkla University, Songkhla, Thailand. rpanthi@medicine.psu.ac.th
P
P
Rujirojindakul
A F
AF
Geater
E B
EB
McNeil
P
P
Vasinanukorn
S
S
Prathep
W
W
Asim
J
J
Naklongdee
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D058109:Airway Management / Q000379:methods*; D000701:Analgesics, Opioid / Q000009:adverse effects; D000758:Anesthesia; D000777:Anesthetics / Q000009:adverse effects; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D016208:Databases, Factual; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications; D007223:Infant; D007239:Infections / Q000150:complications; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012372:ROC Curve; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000150:complications; D012307:Risk Factors; D018401:Sample Size; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult
D000701:Analgesics, Opioid; D000777:Anesthetics; D009466:Neuromuscular Blocking Agents