Risk factors for postoperative pulmonary complications in neonates:a retrospective cohort study

查看全文 作　　者：Bin Bin [1]Cai;Dong Pi [1]Wang 机构地区：[1]Department of Anesthesiology,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hang Zhou,China 出　　处：《World Journal of Pediatric Surgery》索引2023年第6卷第4期,共8页 摘　　要：Objective Postoperative pulmonary complications(PPCs)are an important quality indicator and are associated with significantly increased mortality in infants.The objective of this study was to identify risk factors for PPCs in neonates undergoing non-cardiothoracic surgery.Methods In this retrospective study,all neonates who underwent non-cardiothoracic surgery in a children’s hospital from October 2020 to September 2022 were included for analysis.Demographic data and perioperative variables were obtained.The primary outcome was the occurrence of PPCs.Univariate analysis and multivariable logistic regression analysis were used to investigate the effect of patient-related factors on the occurrence of PPCs.Results Totally,867 neonatal surgery patients met the inclusion criteria in this study,among which 35.3%(306/867)patients experienced pulmonary complications within 1 week postoperatively.The PPCs observed in this study were 51 exacerbations of pre-existing pneumonia,198 new patchy shadows,123 new pulmonary atelectasis,10 new pneumothorax,and 6 new pleural effusion.Patients were divided into two groups:PPCs(n=306)and non-PPCs(n=561).The multivariate stepwise logistic regression analysis revealed five independent risk factors for PPCs:corrected gestational age(OR=0.938;95%CI 0.890 to 0.988),preoperative pneumonia(OR=2.139;95%CI 1.033 to 4.426),length of surgery(>60 min)(OR=1.699;95%CI 1.134 to 2.548),preoperative mechanical ventilation(OR=1.857;95%CI 1.169 to 2.951),and intraoperative albumin infusion(OR=1.456;95%CI 1.041 to 2.036)in neonates undergoing non-cardiothoracic surgery.Conclusion Identifying risk factors for neonatal PPCs will allow for the identification of patients who are at higher risk and intervention for any modifiable risk factors identified. 关 键 词：POSTOPERATIVE INFUSION MORTALITY