• Brittany N Burton, Boya Abudu, Pradhan Bhat, Rodney A Gabriel, and Ulrich H Schmidt.
• School of Medicine, University of California San Diego, La Jolla, CA. Electronic address: bnburton@ucsd.edu.
• J. Cardiothorac. Vasc. Anesth. 2019 Sep 1; 33 (9): 2465-2470.

ObjectiveTo examine risk factors associated with 30-day unplanned reintubation after pleurodesis.DesignA retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program surgical outcomes registry.SettingUnited States hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program.ParticipantsThe study comprised 2,358 patients who underwent video-assisted thorascopic surgery for pleurodesis from 2007 to 2016.InterventionsNone.Measurements And Main ResultsThe final sample included 2,358 cases, of which 93 (3.9%) required 30-day unplanned reintubation. Cases with 30-day unplanned reintubation, compared to those without, had higher unadjusted rates of American Society of Anesthesiologists physical status (ASA PS) score ≥4 (54.8% v 27.2%), preoperative dyspnea (71% v 57%), congestive heart failure (14% v 5.4%), functional dependence (28% v 10.3%), and diabetes mellitus (29% v 17.8%) (all p < 0.05). Patients with 30-day reintubation experienced higher unadjusted rates of 30-day outcomes including mortality (50.5% v 10.1%), pneumonia (28% v 4.9%), ventilator dependence (50.5% v 10.1%), sepsis (7.5% v 1.9%), myocardial infarction (5.4% v 0.1%), cardiac arrest (18.3% v 0.6%), transfusion (14% v 4.5%), and reoperation (15.1% v 3.2%) (all p < 0.05). The odds of 30-day unplanned reintubation were increased significantly on multivariable analysis for patients with ASA PS score ≥4, functional dependence, disseminated cancer, renal dialysis, and weight loss (all p < 0.05).ConclusionGiven the dearth of population-based studies addressing risk factors of reintubation after pleurodesis, this study suggests further review of preoperative optimization, which is required to improve patient outcomes and safety.Copyright © 2019 Elsevier Inc. All rights reserved.

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