26 April 2021: Clinical Research
Risk Factors for the Development of Intraoperative Hypoxia in Patients Undergoing Nonintubated Video-Assisted Thoracic Surgery: A Retrospective Study from a Single Center
Lan Lan 1AE* , Yanyi Cen 1BD , Long Jiang 23BF , Huazhang Miao 4C , Weixiang Lu 23BDOI: 10.12659/MSM.928965
Med Sci Monit 2021; 27:e928965
Table 1 Preoperative characteristics of patients with or without hypoxia.
| Variables | Before matching | After matching | ||||
|---|---|---|---|---|---|---|
| Nonhypoxia (n=2497) | Hypoxia (n=245) | P value | Nonhypoxia (n=240) | Hypoxia (n=240) | P value | |
| Age, y | 44.48±16.71 | 47.32±16.68 | 0.011 | 46.24±17.46 | 47.02±16.62 | 0.619 |
| Age, n (%) | 0.046 | 0.883 | ||||
| 18–44 y | 1149 (46) | 101 (41) | 105 (43) | 100 (42) | ||
| 45–59 y | 810 (32) | 78 (32) | 69 (29) | 78 (32) | ||
| 60–74 y | 497 (20) | 59 (24) | 60 (25) | 55 (23) | ||
| ≥75 y | 41 (2) | 7 (3) | 6 (3) | 7 (3) | ||
| Sex, n (%) | 0.435 | 0.310 | ||||
| Male | 1444 (58) | 148 (60) | 133 (55) | 144 (60) | ||
| Female | 1053 (42) | 97 (40) | 107 (45) | 96 (40) | ||
| BMI, kg/m | 21.55±3.02 | 21.99±3.09 | 0.033 | 21.85±3.08 | 21.95±3.08 | 0.213 |
| ASA physical status, n (%) | 0.140 | 0.331 | ||||
| I | 1984 (80) | 185 (76) | 193 (80) | 184 (77) | ||
| II | 470 (19) | 54 (22) | 41 (17) | 50 (21) | ||
| III | 43 (2) | 6 (2) | 6 (3) | 6 (2) | ||
| Previous medical history, n (%) | ||||||
| Smoking history | 450 (18) | 37 (15) | 0.254 | 41 (17) | 36 (15) | 0.534 |
| Cardiovascular disease | 187 (8) | 23 (9) | 0.286 | 20 (8) | 22 (9) | 0.747 |
| Diabetes | 79 (3) | 7 (3) | 0.793 | 11 (5) | 5 (2) | 0.127 |
| Pulmonary operation history | 73 (3) | 7 (3) | 0.953 | 3 (1) | 7 (3) | 0.202 |
| Pulmonary disease | 129 (5) | 14 (6) | 0.713 | 12 (5) | 12 (5) | 1.000 |
| Hepatic dysfunction | 33 (1) | 5 (2) | 0.358 | 6 (3) | 5 (2) | 0.761 |
| Neurologic diseases | 39 (2) | 5 (2) | 0.569 | 2 (1) | 5 (2) | 0.254 |
| Nonpulmonary cancer | 66 (3) | 8 (3) | 0.566 | 7 (3) | 8 (3) | 0.793 |
| RCRI, n (%) | 0.031 | 0.704 | ||||
| 1 point | 2479 (99) | 240 (98) | 236 (98) | 237 (99) | ||
| 2 points | 18 (1) | 5 (2) | 4 (2) | 3 (1) | ||
| Stair climbing | 0.001 | |||||
| ≥22 m | 2473 (99) | 235 (96) | 240 (100) | 230 (96) | ||
| 24 (1) | 10 (4) | 0 | 10 (4) | |||
| LVEF, n (%) | n=212771.02±5.35 | n=21271.44±7.15 | 0.292 | n=20871.08±5.14 | n=20771.48±7.14 | 0.511 |
| Pulmonary function tests, n (%) | n=1659 | n=178 | n=154 | n=170 | ||
| FVE% predicted | 92.90±18.47 | 92.04±18.70 | 0.555 | 91.98±17.94 | 92.06±18.82 | 0.968 |
| FVC% predicted | 95.31±18.37 | 93.63±18.41 | 0.245 | 92.99±19.39 | 94.02±18.21 | 0.616 |
| FEV/FVC% predicted | 96.88±11.72 | 97.90±11.72 | 0.272 | 96.88±12.30 | 98.08±11.38 | 0.354 |
| Types of thoracic procedure, n (%) | 0.033 | 0.895 | ||||
| Nonanatomical lung surgery | 1482 (59) | 127 (52) | 131 (54) | 126 (53) | ||
| Anatomical lung surgery | 615 (25) | 70 (29) | 54 (22) | 68 (28) | ||
| Mediastinal mass resection | 174 (7) | 27 (11) | 23 (10) | 27 (11) | ||
| Bilateral sympathectomy | 81 (3) | 9 (4) | 23 (10) | 10 (4) | ||
| Other surgery | 145 (6) | 12 (5) | 9 (4) | 9 (4) | ||
| Surgical location, n (%) | 0.241 | 0.801 | ||||
| Left lung | 1042 (42) | 85 (35) | 90 (37) | 83 (34) | ||
| Right lung | 1086 (44) | 132 (54) | 108 (45) | 130 (54) | ||
| Mediastinum | 340 (14) | 24 (10) | 42 (18) | 23 (10) | ||
| Left and right lung | 29 (1) | 4 (2) | 0 | 4 (2) | ||
| Anesthesia methods, n (%) | 0.005 | 0.540 | ||||
| TCI+LMA | 1975 (79) | 175 (71) | 177 (74) | 171 (71) | ||
| EA | 522 (21) | 70 (29) | 63 (26) | 69 (29) | ||
| Technical level of surgeons, n (%) | 0.009 | 0.819 | ||||
| VATS training ≤5 y | 355 (14) | 31 (13) | 49 (20) | 30 (12) | ||
| VATS training 6–10 y | 559 (22) | 85 (35) | 49 (20) | 81 (34) | ||
| VATS training ≥10 y | 1583 (63) | 129 (52) | 142 (60) | 129 (54) | ||
| Technical level of anesthetists, n (%) | 0.203 | 0.050 | ||||
| Attending | 2082 (83) | 212 (87) | 192 (80) | 208 (87) | ||
| Residents | 415 (17) | 33 (13) | 48 (20) | 32 (13) | ||
| ASA – American Society of Anesthesiologists; BMI – body mass index; EA – epidural anesthesia; FEV% predicted – the forced expiratory volume in the first second in percent of predicted; TCI – target-controlled infusion; FVC% predicted – the forced vital capacity in percent of predicted; LMA – laryngeal mask airway; LVEF – left ventricular ejection fraction; RCRI – revised cardiac risk index; VATS – video-assisted thoracic surgery. | ||||||