Journal CME - 2016 November
Back to Journal CME - 2016 November
Journal CME - 2016 November

Journal CME - 2016 November

Summary:

Background: To date, the independent predictors and outcomes of unplanned postoperative intubation (UPI ) in pediatric patients after noncardiac surgery are yet to be characterized. The authors aimed to identify the incidence and predictors of this event and evaluated the effect of this event on postoperative mortality.

Methods: Data of 87,920 patients from the American College of Surgeons National Surgical Quality Improvement Program Pediatric database were analyzed and assigned to derivation (n = 58,614; 66.7%) or validation (n = 29,306; 33.3%) cohorts. The derivation cohort was analyzed for the incidence and independent predictors of early UPI . The final multivariable logistic regression model was validated using the validation cohort.

Results: Early UPI occurred with an incidence of 0.2% in both cohorts. Among the 540 patients who experienced a UPI, 178 (33.0%) were intubated within the first 72 h after surgery. The final logistic regression model indicated operation time, severe cardiac risk factors, American Society of Anesthesiologists physical status classification more than or equal to 2, tumor involving the central nervous system, developmental delay/impaired cognitive function, past or current malignancy, and neonate status as independent predictors of early UPI . Having an early UPI was associated with an increased risk of unadjusted, all-cause 30-day mortality, demonstrating an odds ratio of 11.4 (95% CI, 5.8 to 22.4).

Conclusions: Pediatric patients who experienced an early UPI after noncardiac surgery had an increased likelihood of unadjusted 30-day mortality by more than 11-fold. Identification of high-risk patients can allow for targeted intervention and potential prevention of such outcomes.

CME Credit: 1.00 AMA PRA Category 1 Credit™

Required Hardware / Software:
Adobe Acrobat Reader, Internet connection. Web browser version must have been released within the last three years.

Activity Release Date:
10/18/2016

Activity Expiration Date:
10/17/2019

  • List Price: $20.00
  • Member Price: Free
 
Want to save more?
Log into see if you qualify for a lower rate.
Members save $20.00 or more Join
Item Details:

Learning Objectives:
After successfully completing this activity, the learner will be able to do the following:

  1. Recognize the risk factors for unplanned postoperative intubation (UPI) in pediatric patients.

  2. Adjust clinical management based on the effect of UPI in pediatric patients.

  3. Recognize...

Back to Journal CME - 2016 November
View More View Less
Back to Product Detail
There are not any reviews for this product.

Thank You Industry Supporters

Whose contributions allow the American Society of Anesthesiologists® to create world-class education and resources to improve patient care and outcomes.

Learn More