Demographic and Clinical Variables Associated With 30-day Re-Intubation Following Surgical Aortic Valve Replacement

Abstract

BACKGROUND: A retrospective study was performed to evaluate factors associated with 30-d re-intubation following surgical aortic valve repair. We hypothesized a significant increase in the odds of re-intubation among patients with preoperative comorbidities. METHODS: The American College of Surgery National Surgical Quality Improvement Program database from 2007 to 2016 was used to evaluate demographic and clinical factors associated with 30-d re-intubation following surgical aortic valve repair. Multivariable logistic regression was used to report factors associated with 30-d re-intubation while controlling for various patient characteristics. RESULTS: The study population consisted of 5,766 adult subjects who underwent surgical aortic valve repair, of whom 258 (4.47%) were re-intubated within 30 d of surgery. The mean 6 SD age was 69 6 12.98 y, and 3,668 (63.6%) were male. The prevalence of diabetes mellitus, shortness of breath, poor functional status, COPD, congestive heart failure, hypertension, and bleeding disorder was higher among subjects who were re-intubated compared to those who were not (P < .05). Age, severe COPD, congestive heart failure, and bleeding disorder were associated with this outcome. CONCLUSIONS: Age, COPD, congestive heart failure, and bleeding disorder were associated with 30-d re-intubation in this surgical cohort. If surgical aortic valve repair is deemed non-emergent, patients should be optimized preoperatively and receive careful postoperative planning to reduce the risk of postoperative complications.

Management of Postoperative Hypoxemia

“…20,21 In the subjects after surgical aortic valve replacement, age, COPD, congestive heart failure, and bleeding disorders were associated with 30-d re-intubation. 22 Similarly, in subjects after thoracic surgery, American Society of Anesthesiology physical status classification of $ III, surgery duration > 80 min, fluid balance during operation > 4,000 mL were found to be independent risk factors of postoperative hypoxemia. [23][24][25][26][27][28] During abdominal surgery, including hepatectomy, upper or upper and lower (vs lower) abdominal incision, multiple procedures (vs one), crystalloid replacement > 6 L, and total surgery duration > 5 h were found to be risk factors.…”