Patient-centered care for postoperative reintubation after posterior occipitocervical fusion: a retrospective cohort...

Patients who have occipitocervical (OC) fusion often have difficult airways and are prone to postoperative airway complications. We performed a retrospective cohort study to identify risk signals associated with reintubation following OC fusion, with the aim of improving the safety of postanesthesia nursing.

In this single-center, retrospective study, electronic medical data were retrieved for patients who underwent posterior OC fusion surgery at West China Hospital, Sichuan University, between 1 January 2016 and 1 April 2024.

Of the 82 included patients who underwent OC fusion surgery, five underwent delayed extubation and seven underwent reintubation. The rates of postoperative reintubation were not significantly different following delayed versus early extubation. Compared with patients without reintubation, significantly more patients with postoperative reintubation had surgeries that lasted longer than 5 h (p < 0.001), received an infusion greater than 3000 mL during surgery (p = 0.02), and were classified as grade III or higher using the American Society of Anesthesiologists Physical Status Classification (p < 0.001).

Our findings suggest potential clinical associations that might influence patient outcomes following OC fusion and assist the planning of extubation strategies in other neurosurgery patients. The following signs associated with reintubation should be considered when deciding between early and delayed extubation: relatively long surgeries (>5 h), large infusion volume (>3000 mL), and/or high physical status classification grades (≥III).