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Updated: Feb 10, 2026
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Dependent functional status is associated with unplanned postoperative intubation after elective cervical spine
Brittany N Burton1, Timothy C Lin1, Alison M A'Court1
1Department of Anesthesiology, University of California, San Diego, 9500 Gilman Dr, MC 0881, La Jolla, San Diego, CA, 92093-0881, USA.
Purpose:
The impact of preoperative functional status on 30-day unplanned postoperative intubation and clinical outcomes among patients who underwent cervical spine surgery is not well-described. We hypothesized that functional dependence is associated with 30-day unplanned postoperative intubation and that among the reintubated cohort, functional dependence is associated with adverse postoperative clinical outcomes after cervical spine surgery.
Methods:
Utilizing the 2007-2016 American College of Surgeons National Surgical Quality Improvement Program database, we identified adult elective anterior and posterior cervical spine surgery patients by Current Procedural Terminology codes. We performed (1) a Cox Proportional Hazard analysis for the following outcomes: reintubation, prolonged ventilator use, and pneumonia and (2) an adjusted logistic regression analysis among patients that required postoperative reintubation to evaluate the association of functional status with adverse postoperative outcomes.
Results:
The sample size was 26,263, of which 550 (2.1%) were functionally dependent. The adjusted model suggested that when compared with functionally independent patients, dependent patients were at increased risk of unplanned 30-day intubation (HR 2.05, 95% CI 1.26-3.34; P = 0.003). The adjusted risk of 30-day postoperative pneumonia was significantly higher in patients with functional dependence (HR 1.61, 95% CI 1.02-2.54, P = 0.036). Among patients that required postoperative reintubation, the odds of 30-day mortality was significantly higher in patients with functional dependence (OR 5.82, 95% CI 1.59-23.4, P < 0.001).
Conclusion:
Preoperative functional dependence is a good marker for estimating postoperative unplanned intubation following cervical spine surgery.
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