Risks for prolonged mechanical ventilation and reintubation after cervical malignant tumor surgery: a nested case–control study
Purpose Prolonged mechanical ventilation (PMV) and reintubation are among the most serious postoperative adverse events associated with malignant cervical tumors. In this study, we aimed to clarify the incidence, characteristics, and risk factors for PMV and reintubation in target patients. Methods...
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| Veröffentlicht in: | European spine journal 2024-08, Vol.33 (8), p.3069-3081 |
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| creator | Yang, Minglei Zhong, Nanzhe Dai, Zeyu Ma, Xiaoyu Leng, Ao Zhou, Yangyang Wang, Jing Jiao, Jian Xiao, Jianru |
| description | Purpose
Prolonged mechanical ventilation (PMV) and reintubation are among the most serious postoperative adverse events associated with malignant cervical tumors. In this study, we aimed to clarify the incidence, characteristics, and risk factors for PMV and reintubation in target patients.
Methods
This retrospective nested case–control study was performed between January 2014 and January 2020 at a large spinal tumor center in China. Univariate analysis was used to identify the possible risk factors associated with PMV and reintubation. Logistic regression analysis was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) with covariates of a probability |
| doi_str_mv | 10.1007/s00586-024-08313-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3071282010</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3071282010</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-6d163ada79613850d33f8481c784b712a57606c88453047a5bc6be138d0fbfe63</originalsourceid><addsrcrecordid>eNp9kc1KHTEUx4Moev14gS5KwI2bqSffGXciVgVBKO06ZDKZ27EzGZtkhLtrn8E39Emaem8ruHB1IOd3fueEP0IfCHwiAOo0AQgtK6C8As0Iq9QWWhDOaAU1o9toATWHSipS76H9lO4BiKhB7qI9pmtQWogF-v2lTz8S7qaIH-I0TGHpWzx6992G3tkBP_qQ-8HmfgrYhhZH34c8N5uHLvuInY-PL-xoh34ZbMg4z2MRpjkufVydYYuDT7mInU3--deTm0Iuy3DKc7s6RDudHZI_2tQD9O3z5deL6-r27urm4vy2clTIXMmWSGZbq2pJmBbQMtZprolTmjeKUCuUBOm05oIBV1Y0Tja-oC10TeclO0Ana2_558-53GPGPjk_DDb4aU6GQbFoCgQKevwGvZ_mGMp1hdKKU0kFLxRdUy5OKUXfmYfYjzauDAHzNyCzDsiUgMxLQEaVoY8b9dyMvv0_8i-RArA1kEqrpBFfd7-j_QPRoZ3t</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3087426254</pqid></control><display><type>article</type><title>Risks for prolonged mechanical ventilation and reintubation after cervical malignant tumor surgery: a nested case–control study</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Yang, Minglei ; Zhong, Nanzhe ; Dai, Zeyu ; Ma, Xiaoyu ; Leng, Ao ; Zhou, Yangyang ; Wang, Jing ; Jiao, Jian ; Xiao, Jianru</creator><creatorcontrib>Yang, Minglei ; Zhong, Nanzhe ; Dai, Zeyu ; Ma, Xiaoyu ; Leng, Ao ; Zhou, Yangyang ; Wang, Jing ; Jiao, Jian ; Xiao, Jianru</creatorcontrib><description><![CDATA[Purpose
Prolonged mechanical ventilation (PMV) and reintubation are among the most serious postoperative adverse events associated with malignant cervical tumors. In this study, we aimed to clarify the incidence, characteristics, and risk factors for PMV and reintubation in target patients.
Methods
This retrospective nested case–control study was performed between January 2014 and January 2020 at a large spinal tumor center in China. Univariate analysis was used to identify the possible risk factors associated with PMV and reintubation. Logistic regression analysis was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) with covariates of a probability < 0.05 in univariate analysis.
Results
From a cohort of 560 patients with primary malignant (n = 352) and metastatic (n = 208) cervical tumors, 27 patients required PMV and 20 patients underwent reintubation. The incidence rates of PMV and reintubation were 4.82% and 3.57%, respectively. Three variables (all
p
< 0.05) were independently associated with an increased risk of PMV: Karnofsky Performance Status < 50 compared to ≥ 80, operation duration ≥ 8 h compared to < 6 h, and C4 nerve root encased by the tumor. Longer operative duration and preoperative hypercapnia (all
p
< 0.05) were independent risk factors for postoperative reintubation, both of which led to longer length of stay (32.6 ± 30.8 vs. 10.7 ± 5.95 days,
p
< 0.001), with an in-hospital mortality of 17.0%.
Conclusion
Our results demonstrate the risk factors for PMV or reintubation after surgery for malignant cervical tumors. Adequate assessment, early detection, and prevention are necessary for this high-risk population.]]></description><identifier>ISSN: 0940-6719</identifier><identifier>ISSN: 1432-0932</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-024-08313-7</identifier><identifier>PMID: 38907855</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Case-Control Studies ; Cervical cancer ; Cervical Vertebrae - surgery ; Female ; Humans ; Hypercapnia ; Intubation, Intratracheal - adverse effects ; Intubation, Intratracheal - statistics & numerical data ; Male ; Mechanical ventilation ; Medicine ; Medicine & Public Health ; Metastases ; Middle Aged ; Neurosurgery ; Original Article ; Patients ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Respiration, Artificial - statistics & numerical data ; Retrospective Studies ; Risk Factors ; Spinal Neoplasms - surgery ; Surgery ; Surgical Orthopedics ; Tumors ; Ventilation</subject><ispartof>European spine journal, 2024-08, Vol.33 (8), p.3069-3081</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-6d163ada79613850d33f8481c784b712a57606c88453047a5bc6be138d0fbfe63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-024-08313-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-024-08313-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38907855$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Minglei</creatorcontrib><creatorcontrib>Zhong, Nanzhe</creatorcontrib><creatorcontrib>Dai, Zeyu</creatorcontrib><creatorcontrib>Ma, Xiaoyu</creatorcontrib><creatorcontrib>Leng, Ao</creatorcontrib><creatorcontrib>Zhou, Yangyang</creatorcontrib><creatorcontrib>Wang, Jing</creatorcontrib><creatorcontrib>Jiao, Jian</creatorcontrib><creatorcontrib>Xiao, Jianru</creatorcontrib><title>Risks for prolonged mechanical ventilation and reintubation after cervical malignant tumor surgery: a nested case–control study</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description><![CDATA[Purpose
Prolonged mechanical ventilation (PMV) and reintubation are among the most serious postoperative adverse events associated with malignant cervical tumors. In this study, we aimed to clarify the incidence, characteristics, and risk factors for PMV and reintubation in target patients.
Methods
This retrospective nested case–control study was performed between January 2014 and January 2020 at a large spinal tumor center in China. Univariate analysis was used to identify the possible risk factors associated with PMV and reintubation. Logistic regression analysis was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) with covariates of a probability < 0.05 in univariate analysis.
Results
From a cohort of 560 patients with primary malignant (n = 352) and metastatic (n = 208) cervical tumors, 27 patients required PMV and 20 patients underwent reintubation. The incidence rates of PMV and reintubation were 4.82% and 3.57%, respectively. Three variables (all
p
< 0.05) were independently associated with an increased risk of PMV: Karnofsky Performance Status < 50 compared to ≥ 80, operation duration ≥ 8 h compared to < 6 h, and C4 nerve root encased by the tumor. Longer operative duration and preoperative hypercapnia (all
p
< 0.05) were independent risk factors for postoperative reintubation, both of which led to longer length of stay (32.6 ± 30.8 vs. 10.7 ± 5.95 days,
p
< 0.001), with an in-hospital mortality of 17.0%.
Conclusion
Our results demonstrate the risk factors for PMV or reintubation after surgery for malignant cervical tumors. Adequate assessment, early detection, and prevention are necessary for this high-risk population.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Case-Control Studies</subject><subject>Cervical cancer</subject><subject>Cervical Vertebrae - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Hypercapnia</subject><subject>Intubation, Intratracheal - adverse effects</subject><subject>Intubation, Intratracheal - statistics & numerical data</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Patients</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Respiration, Artificial - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Spinal Neoplasms - surgery</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Tumors</subject><subject>Ventilation</subject><issn>0940-6719</issn><issn>1432-0932</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1KHTEUx4Moev14gS5KwI2bqSffGXciVgVBKO06ZDKZ27EzGZtkhLtrn8E39Emaem8ruHB1IOd3fueEP0IfCHwiAOo0AQgtK6C8As0Iq9QWWhDOaAU1o9toATWHSipS76H9lO4BiKhB7qI9pmtQWogF-v2lTz8S7qaIH-I0TGHpWzx6992G3tkBP_qQ-8HmfgrYhhZH34c8N5uHLvuInY-PL-xoh34ZbMg4z2MRpjkufVydYYuDT7mInU3--deTm0Iuy3DKc7s6RDudHZI_2tQD9O3z5deL6-r27urm4vy2clTIXMmWSGZbq2pJmBbQMtZprolTmjeKUCuUBOm05oIBV1Y0Tja-oC10TeclO0Ana2_558-53GPGPjk_DDb4aU6GQbFoCgQKevwGvZ_mGMp1hdKKU0kFLxRdUy5OKUXfmYfYjzauDAHzNyCzDsiUgMxLQEaVoY8b9dyMvv0_8i-RArA1kEqrpBFfd7-j_QPRoZ3t</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Yang, Minglei</creator><creator>Zhong, Nanzhe</creator><creator>Dai, Zeyu</creator><creator>Ma, Xiaoyu</creator><creator>Leng, Ao</creator><creator>Zhou, Yangyang</creator><creator>Wang, Jing</creator><creator>Jiao, Jian</creator><creator>Xiao, Jianru</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20240801</creationdate><title>Risks for prolonged mechanical ventilation and reintubation after cervical malignant tumor surgery: a nested case–control study</title><author>Yang, Minglei ; Zhong, Nanzhe ; Dai, Zeyu ; Ma, Xiaoyu ; Leng, Ao ; Zhou, Yangyang ; Wang, Jing ; Jiao, Jian ; Xiao, Jianru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-6d163ada79613850d33f8481c784b712a57606c88453047a5bc6be138d0fbfe63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Case-Control Studies</topic><topic>Cervical cancer</topic><topic>Cervical Vertebrae - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Hypercapnia</topic><topic>Intubation, Intratracheal - adverse effects</topic><topic>Intubation, Intratracheal - statistics & numerical data</topic><topic>Male</topic><topic>Mechanical ventilation</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Patients</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Respiration, Artificial - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Spinal Neoplasms - surgery</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Tumors</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Minglei</creatorcontrib><creatorcontrib>Zhong, Nanzhe</creatorcontrib><creatorcontrib>Dai, Zeyu</creatorcontrib><creatorcontrib>Ma, Xiaoyu</creatorcontrib><creatorcontrib>Leng, Ao</creatorcontrib><creatorcontrib>Zhou, Yangyang</creatorcontrib><creatorcontrib>Wang, Jing</creatorcontrib><creatorcontrib>Jiao, Jian</creatorcontrib><creatorcontrib>Xiao, Jianru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Minglei</au><au>Zhong, Nanzhe</au><au>Dai, Zeyu</au><au>Ma, Xiaoyu</au><au>Leng, Ao</au><au>Zhou, Yangyang</au><au>Wang, Jing</au><au>Jiao, Jian</au><au>Xiao, Jianru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risks for prolonged mechanical ventilation and reintubation after cervical malignant tumor surgery: a nested case–control study</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>33</volume><issue>8</issue><spage>3069</spage><epage>3081</epage><pages>3069-3081</pages><issn>0940-6719</issn><issn>1432-0932</issn><eissn>1432-0932</eissn><abstract><![CDATA[Purpose
Prolonged mechanical ventilation (PMV) and reintubation are among the most serious postoperative adverse events associated with malignant cervical tumors. In this study, we aimed to clarify the incidence, characteristics, and risk factors for PMV and reintubation in target patients.
Methods
This retrospective nested case–control study was performed between January 2014 and January 2020 at a large spinal tumor center in China. Univariate analysis was used to identify the possible risk factors associated with PMV and reintubation. Logistic regression analysis was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) with covariates of a probability < 0.05 in univariate analysis.
Results
From a cohort of 560 patients with primary malignant (n = 352) and metastatic (n = 208) cervical tumors, 27 patients required PMV and 20 patients underwent reintubation. The incidence rates of PMV and reintubation were 4.82% and 3.57%, respectively. Three variables (all
p
< 0.05) were independently associated with an increased risk of PMV: Karnofsky Performance Status < 50 compared to ≥ 80, operation duration ≥ 8 h compared to < 6 h, and C4 nerve root encased by the tumor. Longer operative duration and preoperative hypercapnia (all
p
< 0.05) were independent risk factors for postoperative reintubation, both of which led to longer length of stay (32.6 ± 30.8 vs. 10.7 ± 5.95 days,
p
< 0.001), with an in-hospital mortality of 17.0%.
Conclusion
Our results demonstrate the risk factors for PMV or reintubation after surgery for malignant cervical tumors. Adequate assessment, early detection, and prevention are necessary for this high-risk population.]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38907855</pmid><doi>10.1007/s00586-024-08313-7</doi><tpages>13</tpages></addata></record> |
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| ispartof | European spine journal, 2024-08, Vol.33 (8), p.3069-3081 |
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| subjects | Adult Aged Case-Control Studies Cervical cancer Cervical Vertebrae - surgery Female Humans Hypercapnia Intubation, Intratracheal - adverse effects Intubation, Intratracheal - statistics & numerical data Male Mechanical ventilation Medicine Medicine & Public Health Metastases Middle Aged Neurosurgery Original Article Patients Postoperative Complications - epidemiology Postoperative Complications - etiology Respiration, Artificial - statistics & numerical data Retrospective Studies Risk Factors Spinal Neoplasms - surgery Surgery Surgical Orthopedics Tumors Ventilation |
| title | Risks for prolonged mechanical ventilation and reintubation after cervical malignant tumor surgery: a nested case–control study |
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