Balancing intubation time with postoperative risk in cardiac surgery patients – a retrospective cohort analysis
Katarzyna Kotfis,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Kacper Lechowicz,1 Monika Kosiorowska,3 Sylwester Drożdżal,1 Mirosław Brykczyński,3 Iwona Rotter,2 Maciej Żukowski1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2018-11-01
|
Series: | Therapeutics and Clinical Risk Management |
Subjects: | |
Online Access: | https://www.dovepress.com/balancing-intubation-time-with-postoperative-risk-in-cardiac-surgery-p-peer-reviewed-article-TCRM |
_version_ | 1819006188506841088 |
---|---|
author | Kotfis K Szylińska A Listewnik M Lechowicz K Kosiorowska M Drożdżal S Brykczyński M Rotter I Żukowski M |
author_facet | Kotfis K Szylińska A Listewnik M Lechowicz K Kosiorowska M Drożdżal S Brykczyński M Rotter I Żukowski M |
author_sort | Kotfis K |
collection | DOAJ |
description | Katarzyna Kotfis,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Kacper Lechowicz,1 Monika Kosiorowska,3 Sylwester Drożdżal,1 Mirosław Brykczyński,3 Iwona Rotter,2 Maciej Żukowski1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland; 2Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland; 3Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland Introduction: Intubation time in patients undergoing cardiac surgery may be associated with increased mortality and morbidity. Premature extubation can have serious adverse physiological consequences. The aim of this study was to determine the influence of intubation time on morbidity and mortality in patients undergoing cardiac surgery.Methods: We performed a retrospective analysis of data on 1,904 patients undergoing isolated coronary artery bypass grafting (CABG) and stratified them by duration of intubation time after surgery – 0–6, 6–9, 9–12, 12–24 and over 24 hours. Postoperative complications risk analysis was performed using multivariate logistic regression analysis for patients extubated ≤12 and >12 hours.Results: Intubation percentages in each time cohort were as follows: 0–6 hours – 7.8%, 6–9 hours – 17.3%, 9–12 hours – 26.8%, 12–24 hours – 44.4% and >24 hours – 3.7%. Patients extubated ≤12 hours after CABG were younger, mostly males, more often smokers, with lower preoperative risk. They had lower 30-day mortality (2.02% vs 4.59%, P=0.002), shorter hospital stay (7.68±4.49 vs 9.65±12.63 days, P<0.001) and shorter intensive care unit stay (2.39 vs 3.30 days, P<0.001). Multivariate analysis showed that intubation exceeding 12 hours after CABG increases the risk of postoperative delirium (OR 1.548, 95% CI 1.161–2.064, P=0.003) and risk of postoperative hemofiltration (OR 1.302, 95% CI 1.023–1.657, P=0.032).Conclusion: Results indicate that risk of postoperative complications does not increase until intubation time exceeds 12 hours. Shorter intubation time is seen in younger, men and smokers. Intubation time >12 hours is a risk factor for postoperative delirium and hemofiltration after cardiac surgery. Keywords: intubation, cardiac surgery, CABG, mortality, complications, delirium |
first_indexed | 2024-12-21T00:04:43Z |
format | Article |
id | doaj.art-0d4f498d681843ad9109ebf9a1ee076c |
institution | Directory Open Access Journal |
issn | 1178-203X |
language | English |
last_indexed | 2024-12-21T00:04:43Z |
publishDate | 2018-11-01 |
publisher | Dove Medical Press |
record_format | Article |
series | Therapeutics and Clinical Risk Management |
spelling | doaj.art-0d4f498d681843ad9109ebf9a1ee076c2022-12-21T19:22:30ZengDove Medical PressTherapeutics and Clinical Risk Management1178-203X2018-11-01Volume 142203221242054Balancing intubation time with postoperative risk in cardiac surgery patients – a retrospective cohort analysisKotfis KSzylińska AListewnik MLechowicz KKosiorowska MDrożdżal SBrykczyński MRotter IŻukowski MKatarzyna Kotfis,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Kacper Lechowicz,1 Monika Kosiorowska,3 Sylwester Drożdżal,1 Mirosław Brykczyński,3 Iwona Rotter,2 Maciej Żukowski1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland; 2Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland; 3Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland Introduction: Intubation time in patients undergoing cardiac surgery may be associated with increased mortality and morbidity. Premature extubation can have serious adverse physiological consequences. The aim of this study was to determine the influence of intubation time on morbidity and mortality in patients undergoing cardiac surgery.Methods: We performed a retrospective analysis of data on 1,904 patients undergoing isolated coronary artery bypass grafting (CABG) and stratified them by duration of intubation time after surgery – 0–6, 6–9, 9–12, 12–24 and over 24 hours. Postoperative complications risk analysis was performed using multivariate logistic regression analysis for patients extubated ≤12 and >12 hours.Results: Intubation percentages in each time cohort were as follows: 0–6 hours – 7.8%, 6–9 hours – 17.3%, 9–12 hours – 26.8%, 12–24 hours – 44.4% and >24 hours – 3.7%. Patients extubated ≤12 hours after CABG were younger, mostly males, more often smokers, with lower preoperative risk. They had lower 30-day mortality (2.02% vs 4.59%, P=0.002), shorter hospital stay (7.68±4.49 vs 9.65±12.63 days, P<0.001) and shorter intensive care unit stay (2.39 vs 3.30 days, P<0.001). Multivariate analysis showed that intubation exceeding 12 hours after CABG increases the risk of postoperative delirium (OR 1.548, 95% CI 1.161–2.064, P=0.003) and risk of postoperative hemofiltration (OR 1.302, 95% CI 1.023–1.657, P=0.032).Conclusion: Results indicate that risk of postoperative complications does not increase until intubation time exceeds 12 hours. Shorter intubation time is seen in younger, men and smokers. Intubation time >12 hours is a risk factor for postoperative delirium and hemofiltration after cardiac surgery. Keywords: intubation, cardiac surgery, CABG, mortality, complications, delirium https://www.dovepress.com/balancing-intubation-time-with-postoperative-risk-in-cardiac-surgery-p-peer-reviewed-article-TCRMintubationcardiac surgeryCABGmortalitycomplicationsdelirium |
spellingShingle | Kotfis K Szylińska A Listewnik M Lechowicz K Kosiorowska M Drożdżal S Brykczyński M Rotter I Żukowski M Balancing intubation time with postoperative risk in cardiac surgery patients – a retrospective cohort analysis Therapeutics and Clinical Risk Management intubation cardiac surgery CABG mortality complications delirium |
title | Balancing intubation time with postoperative risk in cardiac surgery patients – a retrospective cohort analysis |
title_full | Balancing intubation time with postoperative risk in cardiac surgery patients – a retrospective cohort analysis |
title_fullStr | Balancing intubation time with postoperative risk in cardiac surgery patients – a retrospective cohort analysis |
title_full_unstemmed | Balancing intubation time with postoperative risk in cardiac surgery patients – a retrospective cohort analysis |
title_short | Balancing intubation time with postoperative risk in cardiac surgery patients – a retrospective cohort analysis |
title_sort | balancing intubation time with postoperative risk in cardiac surgery patients ndash a retrospective cohort analysis |
topic | intubation cardiac surgery CABG mortality complications delirium |
url | https://www.dovepress.com/balancing-intubation-time-with-postoperative-risk-in-cardiac-surgery-p-peer-reviewed-article-TCRM |
work_keys_str_mv | AT kotfisk balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis AT szylinskaa balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis AT listewnikm balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis AT lechowiczk balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis AT kosiorowskam balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis AT drozdzals balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis AT brykczynskim balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis AT rotteri balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis AT zukowskim balancingintubationtimewithpostoperativeriskincardiacsurgerypatientsndasharetrospectivecohortanalysis |