Rhabdomyolysis After Tracheobronchoplasty: Incidence, Predictors, and Association With Postoperative Outcomes

Area of Science:

• Thoracic Surgery
• Nephrology
• Critical Care Medicine

Background:

• Prolonged intraoperative immobility during tracheobronchoplasty (TBP) is a known risk factor for rhabdomyolysis.
• Rhabdomyolysis, a condition involving muscle breakdown, can have significant implications for patient recovery.

Purpose of the Study:

• To determine the incidence of rhabdomyolysis following TBP.
• To investigate the association between rhabdomyolysis severity and postoperative outcomes.

Main Methods:

• A single-center retrospective review of 232 TBP patients (2008-2024).
• Patients were categorized by rhabdomyolysis severity (none, mild, moderate, severe).
• Statistical analyses included Fisher's exact test, Wilcoxon rank sum test, and logistic regression.

Main Results:

• 4.7% of patients did not develop rhabdomyolysis; 56.4% had mild, 36.6% moderate, and 2.1% severe cases.
• Moderate/severe rhabdomyolysis was linked to higher BMI, open TBP approach, and longer operative times.
• Acute kidney injury (AKI) was more prevalent in the moderate/severe rhabdomyolysis group (18.9% vs. 11%).

Conclusions:

• The majority of TBP patients experience rhabdomyolysis, with severe cases being uncommon.
• Moderate/severe rhabdomyolysis is associated with younger age, male sex, higher BMI, open surgery, and longer duration.
• While AKI incidence is higher in moderate/severe rhabdomyolysis, overall complication rates remain similar, suggesting effective patient monitoring.