Increased Rate of Poor Laryngoscopic Views in Patients Scheduled for Cardiac Surgery Versus Patients Scheduled for General Surgery: A Propensity Score-Based Analysis of 21,561 Cases

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autor(en): Heinrich S, Ackermann A, Prottengeier J, Castellanos I, Schmidt J, Schüttler J
Zeitschrift: Journal of Cardiothoracic and Vascular Anesthesia
Jahr der Veröffentlichung: 2015
Band: 29
Heftnummer: 6
Seitenbereich: 1537-43
ISSN: 1053-0770


Abstract


Former analyses reported an increased rate of poor direct laryngoscopy view in cardiac surgery patients; however, these findings frequently could be attributed to confounding patient characteristics. In most of the reported cardiac surgery cohorts, the rate of well-known risk factors for poor direct laryngoscopy view such as male sex, obesity, or older age, were increased compared with the control groups. Especially in the ongoing debate on anesthesia staff qualification for cardiac interventions outside the operating room a detailed and stratified risk analysis seems necessary.Retrospective, anonymous, propensity score-based, matched-pair analysis.Single-center study in a university hospital.No active participants. Retrospective, anonymous chart analysis.The anesthesia records of patients undergoing cardiac surgery in a period of 6 consecutive years were analyzed retrospectively. The results were compared with those of a control group of patients who underwent general surgery. Poor laryngoscopic view was defined as Cormack and Lehane classification grade 3 or 4.The records of 21,561 general anesthesia procedures were reviewed for the study. The incidence of poor direct laryngoscopic views in patients scheduled for cardiac surgery was significantly increased compared with those of the general surgery cohort (7% v 4.2%). Using propensity score-based matched-pair analysis, equal subgroups were generated of each surgical department, with 2,946 patients showing identical demographic characteristics. After stratifying for demographic characteristics, the rate of poor direct laryngoscopy view remained statistically significantly higher in the cardiac surgery group (7.5% v 5.7%).Even with stratification for demographic risk factors, cardiac surgery patients showed a significantly higher rate of poor direct laryngoscopic view compared with general surgery patients. These results should be taken into account for human resource management and distribution of difficult airway equipment, especially when cardiac interventional programs are implemented in remote hospital locations.



FAU-Autoren / FAU-Herausgeber

Ackermann, Andreas Dr. rer. biol. hum.
Anästhesiologische Klinik
Heinrich, Stefan
Lehrstuhl für Innere Medizin V
Prottengeier, Johannes PD Dr.
Anästhesiologische Klinik
Schmidt, Joachim Prof. Dr.
Medizinische Fakultät
Schüttler, Jürgen Prof. Dr.
Lehrstuhl für Anästhesiologie


Zitierweisen

APA:
Heinrich, S., Ackermann, A., Prottengeier, J., Castellanos, I., Schmidt, J., & Schüttler, J. (2015). Increased Rate of Poor Laryngoscopic Views in Patients Scheduled for Cardiac Surgery Versus Patients Scheduled for General Surgery: A Propensity Score-Based Analysis of 21,561 Cases. Journal of Cardiothoracic and Vascular Anesthesia, 29(6), 1537-43. https://dx.doi.org/10.1053/j.jvca.2015.04.027

MLA:
Heinrich, Stefan, et al. "Increased Rate of Poor Laryngoscopic Views in Patients Scheduled for Cardiac Surgery Versus Patients Scheduled for General Surgery: A Propensity Score-Based Analysis of 21,561 Cases." Journal of Cardiothoracic and Vascular Anesthesia 29.6 (2015): 1537-43.

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Zuletzt aktualisiert 2018-06-10 um 02:35