Perioperative risk factors for postoperative pulmonary complications after major oral and maxillofacial surgery with microvascular reconstruction: A retrospective analysis of 648 cases
Perioperative risk factors for postoperative pulmonary complications after major oral and maxillofacial surgery with microvascular reconstruction: A retrospective analysis of 648 cases
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DOI：
10.1016/j.jcms.2016.05.007
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发表时间：
2016-08-01
影响因子：
3.1
通讯作者：
Haseneder, Rainer
中科院分区：
文献类型：
--
作者：
Loeffelbein, Denys J.;Julinek, Annette;Haseneder, Rainer
背景：术后肺部并发症（PPC）很常见，导致住院时间延长、费用增加和死亡率增加。然而，关于口腔颌面部大手术后微血管重建术后肺部并发症（PPC）的发生率和预测因素的数据很少，本回顾性分析确定了口腔颌面部大手术后微血管重建术后肺部并发症（PPC）的围手术期危险因素。方法：对2007年6月至2013年5月期间648例受试者的围手术期数据和患者记录进行了分析。PPC的定义为肺炎、肺不张、胸腔积液、肺栓塞、肺水肿、气胸或呼吸衰竭。PPC的患者相关风险因素为男性、高龄、吸烟、酗酒、体重指数>30、美国麻醉医师协会分级高于2、既往存在肺部疾病和术前抗高血压药物。在研究的手术相关变量中，手术时间、输液量和输血量以及手术期间氧合指数受损均与PPC的发生相关。使用多变量logistic回归模型，我们确定了一个身体质量指数>30，美国麻醉医师协会等级高于2和酗酒作为独立的危险因素PPCs.Conclusions：几个围手术期因素可以确定与PPC的发展。患有一种或多种这些疾病的患者应接受强化的术后肺部护理。(C)2016年欧洲颅颌面外科协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Postoperative pulmonary complications (PPCs) are common and result in prolonged hospital stays, higher costs and increased mortality. However, data on the incidence and predictors of PPCs after major oral and maxillofacial surgery with microvascular reconstruction are rare.This retrospective analysis identifies perioperative risk factors for postoperative pulmonary complications (PPCs) after major oral and maxillofacial surgery with microvascular reconstruction.Methods: Perioperative data and patient records of 648 subjects were analyzed in the period of June 2007 to May 2013. PPCs were defined as pneumonia, atelectasis, pleural effusions, pulmonary embolism, pulmonary oedema, pneumothorax or respiratory failure.Results: 18.8% of all patients developed PPCs. Patient-related risk factors for PPCs were male sex, advanced age, smoking, alcohol abuse, a body mass index >30, American Society of Anaesthesiologists grade higher than 2, pre-existent pulmonary diseases and preoperative antihypertensive medication. Among the investigated procedure-related variables, the length of the operation, the amount of fluid administration and blood transfusion and an impaired oxygenation index during surgery were shown to be associated with the development of PPCs. Using a multivariable logistic regression model, we identified a body mass index >30, American Society of Anaesthesiologists grade higher than 2 and alcohol abuse as independent risk factors for PPCs.Conclusions: Several perioperative factors can be identified that are associated with the development of PPCs. Patients having one or more of these conditions should be subjected to intensified postoperative pulmonary care. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.