Pediatric anesthesia & critical care
Preoperative neurologic comorbidity and unanticipated early postoperative reintubation: a multicentre cohort study
Authors' conclusion
Children with neurologic comorbidities have an increased risk of unanticipated early postoperative reintubation and prolonged mechanical ventilation.
Study context
- Population
- Children undergoing inpatient, elective, noncardiac surgery at National Surgical Quality Improvement Program reporting hospitals, 2012–22propensity score-matched
- Participants
- 420,096 children
- Exposure
- Neurologic comorbidities vs none
- Outcome
- Unanticipated early postoperative reintubation
- Follow-up
- Within 72 h after surgery
Methodological details1:1 propensity score-matched, multicentre
- 1:1 propensity score-matched
- Multicentre
Main finding
As reported in the abstract
within 72 h
- Cerebral palsy vs No neurologic comorbidity
- RRadj 1.97 (95% CI 1.44–2.69); P < 0.01
- Seizure disorders vs No neurologic comorbidity
- RRadj 1.87 (95% CI 1.50–2.34); P < 0.01
- Neuromuscular disorders vs No neurologic comorbidity
- RRadj 1.76 (95% CI 1.41–2.19); P < 0.01
- Structural CNS abnormalities vs No neurologic comorbidity
- RRadj 1.35 (95% CI 1.13–1.61); P < 0.01
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| 30-day mortality, reintubation vs no reintubation | 8.1 (6.0–11.1) | P < 0.01 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
| Outcome | RRadj (95% CI) | P value |
|---|---|---|
| Prolonged postoperative mechanical ventilation (ventilator use >72 h)Seizure disorders vs No neurologic comorbidity | 1.73 (1.55–1.93) | P < 0.01 |
Prolonged postoperative mechanical ventilation (ventilator use >72 h)
- Risk also increased with neurologic comorbidities
Original publication
Preoperative neurologic comorbidity and unanticipated early postoperative reintubation: a multicentre cohort study. Br J Anaesth. Published 20 September 2024. doi:10.
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