TABLE 2].
Perioperative Characteristics: Patients Who Demonstrated PRF Compared With Patients Who Did Not Demonstrate PRF
| Variable | Total Sample (N = 23,999) |
No PRF (n = 23,774) |
All PRF (n = 225) |
P Valuea |
|---|---|---|---|---|
| Anesthesia procedure | ||||
| Anesthesia duration, h | 4.6 (3.3–6.4) | 4.6 (3.3–6.3) | 8.8 (5.8–11.4) | < .001 |
| Surgical specialty | < .001 | |||
| General | 4,706 (19.6) | 4,678 (19.7) | 28 (12.4) | |
| Cardiovascular | 2,898 (12.1) | 2,807 (11.8) | 91 (40.4) | |
| Neurosurgery, including spine | 3,520 (14.7) | 3,487 (14.7) | 33 (14.7) | |
| Oncology | 2,200 (9.2) | 2,179 (9.2) | 21 (9.3) | |
| Orthopedic, nonspine | 5,441 (22.7) | 5,431 (22.8) | 10 (4.4) | |
| Urology, gynecology | 3,336 (13.9) | 3,311 (13.9) | 25 (11.1) | |
| Head, eyes, ears, nose, throat | 1,880 (7.8) | 1,863 (7.8) | 17 (7.6) | |
| Other | 18 (0.1) | 18 (0.1) | 0 (0) | |
| Operations by ICD coding system | < .001 | |||
| Cardiovascular | 1,554 (6.4) | 1,465 (6.2) | 79 (35.1) | |
| Digestive | 4,165 (17.4) | 4,118 (17.3) | 47 (20.9) | |
| Ear | 105 (0.4) | 105 (0.4) | 0 (0) | |
| Endocrine | 678 (2.8) | 676 (2.8) | 2 (0.9) | |
| Eye | 29 (0.1) | 29 (0.1) | 0 (0) | |
| Female genital organs | 1,494 (6.2) | 1,489 (6.3) | 5 (2.2) | |
| Hemic and lymphatic | 675 (2.8) | 671 (2.8) | 4 (1.8) | |
| Integumentary | 1,164 (4.9) | 1,160 (4.9) | 4 (1.8) | |
| Male genital organs | 428 (1.8) | 428 (1.8) | 0 (0) | |
| Musculoskeletal | 7,087 (29.5) | 7,062 (29.7) | 25 (11.1) | |
| Nervous | 1,846 (7.7) | 1,821 (7.7) | 25 (11.1) | |
| Nose, mouth, and pharynx | 499 (2.1) | 495 (2.1) | 4 (1.8) | |
| Obstetric | 51 (0.2) | 51 (0.2) | 0 (0) | |
| Respiratory | 1,022 (4.3) | 1,012 (4.3) | 10 (4.4) | |
| Urinary | 1,882 (7.8) | 1,862 (7.8) | 20 (8.9) | |
| Miscellaneous diagnostic and therapeutic procedures | 8 (< 0.1) | 8 (< 0.1) | 0 (0) | |
| Unable to map to ICD clinical classification system because of annual updates to technical specification and multiyear dataset | 1,322 (5.5) | 1,322 (5.6) | 0 (0) | |
| Surgical duration, h | 3.3 (2.1–4.8) | 3.2 (2.1–4.8) | 6.7 (4.1–9.4) | < .001 |
| Intraoperative ventilator management | ||||
| Tidal volume, mL | 500 (434–550) | 500 (435–550) | 475 (421–536) | .004 |
| Positive end-expiratory pressure, cm H2O | 5 (5–5) | 5 (5–5) | 5 (5–5) | .004 |
| Positive end-expiratory pressure > 5 cm H2O | 4,212 (18.1) | 4,158 (18.0) | 54 (24.3) | .05 |
| Peak inspiratory pressure, cm H2O | 19 (16–23) | 19 (16–23) | 19 (17–23) | .157 |
| Plateau pressure, cm H2O | 18 (16–20) | 18 (16–19) | 21 (16–28) | .359 |
| No. of patients | 32 | 26 | 6 | |
| Respiratory rate | 12 (10–12) | 12 (10–12) | 12 (10–13) | .004 |
| Fio2 | 0.56 (0.49–0.61) | 0.56 (0.49–0.61) | 0.60 (0.53–0.84) | < .001 |
| Oxygen saturation, % | 99 (98–100) | 99 (98–100) | 100 (99–100) | < .001 |
| EtCO2, mm Hg | 35 (33–37) | 35 (33–37) | 34 (32–36) | < .001 |
| Intraoperative fluid management | ||||
| Net fluid in operating room, L | 1.3 (0.8–2.0) | 1.3 (0.8–2.0) | 2.3 (1.1–5.5) | < .001 |
| Net fluid in first 24 h after surgery, L | 0.28 (-0.6 to 1.1) | 0.27 (-0.6 to 1.1) | 1.17 (0.1–2.8) | < .001 |
| Intraoperative medication management | ||||
| Morphine equivalent units, total mg | 90 (71–127) | 90 (71–126) | 147 (82–225) | < .001 |
| Vasopressor medications administered in the operating room (includes bolus dose and continuous infusions), yes/no | 15,112 (63.0) | 14,912 (62.7) | 200 (88.9) | < .001 |
| Vasopressor medications as a continuous, titrated infusion, yes/no | 4,721 (19.7) | 4,594 (19.3) | 127 (56.4) | < .001 |
| Vasopressor medications as a continuous, titrated infusion, count | 1 (1–1) | 1 (1–1) | 1 (1–3) | < .001 |
| No. (%) of patients | 4,721 (19.7) | 4,594 (19.3) | 127 (56.4) | |
| Phenylephrine infusion | 3,778 (15.7) | 3,718 (15.6) | 60 (26.7) | < .001 |
| Norepinephrine infusion | 902 (3.8) | 834 (3.5) | 68 (30.2) | < .001 |
| Vasopressin infusion | 249 (1.0) | 208 (0.9) | 41 (18.2) | < .001 |
| Dopamine infusion | 87 (0.4) | 75 (0.3) | 12 (5.3) | < .001 |
| Dobutamine infusion | 20 (0.1) | 18 (0.1) | 2 (0.9) | < .001 |
| Milrinone infusion | 81 (0.3) | 60 (0.3) | 21 (9.3) | < .001 |
| Intraoperative vital signs | ||||
| Mean arterial pressure, mm Hg | 74 (68–80) | 74 (68–80) | 73 (68–79) | .368 |
| Heart rate, beats/min | 69 (63–77) | 69 (63–77) | 73 (65–80) | < .001 |
| Mechanical ventilation duration | ||||
| First continuous phase after operating room, h | 0 (0–0) | 0 (0–0) | 88.4 (51–177.7) | < .001 |
| Longest continuous phase after operating room, h | 0 (0–0) | 0 (0–0) | 138.6 (78.6–278.0) | < .001 |
| Total duration of all continuous phases after operating room, h | 0 (0–0) | 0 (0–0) | 163.8 (86.5–401.7) | < .001 |
| Reintubation after operating room | ||||
| Reintubated after operating room | 380 (1.6) | 263 (1.1) | 117 (52.0) | < .001 |
| Time from airway removal to reintubation after operating room, h | 0 (0–0) | 0 (0–0) | 51.4 (0–135.1) | < .001 |
Data are presented as No. (%) or median (interquartile range), unless otherwise indicated. EtCO2 = end-tidal carbon dioxide; ICD = International Classification of Diseases; PRF postoperative respiratory failure.
a
Wilcoxon rank-sum test for continuous variables and Pearson’s χ2 test for categorical variables.