Yu V, Pham J, Lukomski L, Joseph J, Guo Y. Comorbidity and Operative Time are Stronger Predictors than Age for Palatoplasty Adverse Airway Events, A NSQIP-P Study of 6668 Cases.
Cleft Palate Craniofac J 2023:10556656231156509. [PMID:
36786023 DOI:
10.1177/10556656231156509]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND
Adverse airway events (AAEs) are rare but devastating complications following palatoplasty. The purpose of this study is to evaluate patient risk factors for their effect on these complications. We hypothesize that prolonged operative time and the presence of multiple medical comorbidities are risk factors for AAEs.
DESIGN
Retrospective cohort study.
SETTING
Participant hospitals in the Pediatric American College of Surgeons National Surgical Quality Improvement Program year 2016-2019.
PATIENTS
Cases of palatoplasty in children under 3 years of age.
OUTCOMES
Adverse airway events including postoperative reintubation or any requirement of postoperative mechanical ventilation.
RESULTS
A total of 6668 patients met inclusion criteria. The median operative time was 126 min (IQR 82). AAEs were identified in 107 (1.6%) patients. The incidence of risk factors was found to increase with age and AAEs were more prevalent in younger and older patients. Although patients in the older age groups had significantly higher burden of comorbidities, differences in age were not independently associated with AAEs. Following multivariable logistic regressions, operative times greater than 2 h, ASA class ≥3, >3 medical comorbidities, and black race were found to be significant independent risk factors.
CONCLUSIONS
In this large, retrospective database study in palatoplasty, increased operative time, ASA classification ≥3, multiple comorbidities, and black race were independently associated with AAEs.
Collapse