Cheon et al studied pediatric patients who required an unplanned postoperative intubation. They identified predictive factors that can help to identify a patient at risk.The authors are from The Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University.
Patient selection: pediatric patient undergoing non-cardiac surgery
Outcome: unplanned postoperative intubation within the first 72 hours after surgery
Risk Factors:
(1) z-score for operation time (OR 1.3 per unit)
(2) severe cardiac risk factors (OR 4.0)
(3) ASA status (ASA 2 OR 2.3; ASA 3 OR 7.6; ASA 4 or 5 OR 10.2)
(4) tumor involving the central nervous system (CNS; OR 2.3)
(5) developmental delay or impaired cognitive function (OR 2.0)
(6) past or current malignancy (OR 2.7)
(7) neonatal status (OR 3.5)
total number of risk factors =
= SUM(risk factor present)
Interpretation:
• minimum number: 0
• maximum number: 7
• The risk of intubation increases as the number of risk factors increase.
• The need to reintubate is associated with a significant increase in 30-day mortality.
|
Total Score
|
Unplanned Intubation
|
OR
|
|
0 or 1
|
0.04%
|
|
|
2
|
0.32%
|
8.5 tp 13.7
|
|
3
|
0.67%
|
18.2 to 34.3
|
|
4 or 5
|
1.34%
|
36.3 to 49
|
|
6 or 7
|
2.46%
|
67.5 to 87.8
|
