Independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia: A time-matched, case control study
Background and Aims: Postanesthetic reintubation is associated with increased morbidities and mortality; however, it can be reduced with defined predictors and using a score as a tool. This study aimed to identify independent predictors and develop a reliable predictive score. Material and Methods:...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-01-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/joacp.joacp_213_22 |
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| author | Chidchanok Choovongkomol Thidarat Ariyanuchitkul Kongtush Choovongkomol Vipanee Tongjapo |
| author_facet | Chidchanok Choovongkomol Thidarat Ariyanuchitkul Kongtush Choovongkomol Vipanee Tongjapo |
| author_sort | Chidchanok Choovongkomol |
| collection | DOAJ |
| description | Background and Aims:
Postanesthetic reintubation is associated with increased morbidities and mortality; however, it can be reduced with defined predictors and using a score as a tool. This study aimed to identify independent predictors and develop a reliable predictive score.
Material and Methods:
A retrospective, time-matched, case control study was conducted on patients who underwent general anesthesia between October 2017 and September 2021. Using stepwise multivariable logistic regression analysis, predictors were determined and the predictive score was developed and validated.
Results:
Among 230 patients, 46 were in the reintubated group. Significant independent predictors included age >65 years (odds ratio [OR] 2.96 [95% confidence interval {CI} 1.23, 7.10]), the American Society of Anesthesiologists physical status III–IV (OR 6.60 [95%CI 2.50 17.41]), body mass index (BMI) ≥30 kg/m2 (OR 4.91 [95% CI 1.55, 15.51]), and head and neck surgery (OR 4.35 [95% CI 1.46, 12.87]). The predictive model was then developed with an area under the receiver operating characteristic curve (AUC) of 0.84 (95% CI 0.78, 0.90). This score ranged from 0 to 29 and was classified into three subcategories for clinical practicability, in which the positive predictive values were 6.01 (95% CI 2.63, 11.50) for low risk, 18.64 (95% CI 9.69, 30.91) for moderate risk, and 71.05 (95% CI 54.09, 84.58) for high risk.
Conclusion:
The independent predictors for postanesthetic reintubation according to this simplified risk-based scoring system designed to aid anesthesiologists before extubation were found to be advanced age, higher American Society of Anesthesiologists physical status, obesity, and head and neck surgery. |
| format | Article |
| id | doaj-art-1cb6e4012e1847dd85fbcd0e11e7101d |
| institution | OA Journals |
| issn | 0970-9185 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj-art-1cb6e4012e1847dd85fbcd0e11e7101d2025-08-20T01:58:27ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852024-01-0140112012610.4103/joacp.joacp_213_22Independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia: A time-matched, case control studyChidchanok ChoovongkomolThidarat AriyanuchitkulKongtush ChoovongkomolVipanee TongjapoBackground and Aims: Postanesthetic reintubation is associated with increased morbidities and mortality; however, it can be reduced with defined predictors and using a score as a tool. This study aimed to identify independent predictors and develop a reliable predictive score. Material and Methods: A retrospective, time-matched, case control study was conducted on patients who underwent general anesthesia between October 2017 and September 2021. Using stepwise multivariable logistic regression analysis, predictors were determined and the predictive score was developed and validated. Results: Among 230 patients, 46 were in the reintubated group. Significant independent predictors included age >65 years (odds ratio [OR] 2.96 [95% confidence interval {CI} 1.23, 7.10]), the American Society of Anesthesiologists physical status III–IV (OR 6.60 [95%CI 2.50 17.41]), body mass index (BMI) ≥30 kg/m2 (OR 4.91 [95% CI 1.55, 15.51]), and head and neck surgery (OR 4.35 [95% CI 1.46, 12.87]). The predictive model was then developed with an area under the receiver operating characteristic curve (AUC) of 0.84 (95% CI 0.78, 0.90). This score ranged from 0 to 29 and was classified into three subcategories for clinical practicability, in which the positive predictive values were 6.01 (95% CI 2.63, 11.50) for low risk, 18.64 (95% CI 9.69, 30.91) for moderate risk, and 71.05 (95% CI 54.09, 84.58) for high risk. Conclusion: The independent predictors for postanesthetic reintubation according to this simplified risk-based scoring system designed to aid anesthesiologists before extubation were found to be advanced age, higher American Society of Anesthesiologists physical status, obesity, and head and neck surgery.https://journals.lww.com/10.4103/joacp.joacp_213_22airway extubationairway managementanesthesia recovery periodsintubationpredict modelprognostic |
| spellingShingle | Chidchanok Choovongkomol Thidarat Ariyanuchitkul Kongtush Choovongkomol Vipanee Tongjapo Independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia: A time-matched, case control study Journal of Anaesthesiology Clinical Pharmacology airway extubation airway management anesthesia recovery periods intubation predict model prognostic |
| title | Independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia: A time-matched, case control study |
| title_full | Independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia: A time-matched, case control study |
| title_fullStr | Independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia: A time-matched, case control study |
| title_full_unstemmed | Independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia: A time-matched, case control study |
| title_short | Independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia: A time-matched, case control study |
| title_sort | independent predictors and clinical predictive score of postanesthetic reintubation after general anesthesia a time matched case control study |
| topic | airway extubation airway management anesthesia recovery periods intubation predict model prognostic |
| url | https://journals.lww.com/10.4103/joacp.joacp_213_22 |
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