Analysis Of Risk Factors For Delayed Extubation After Esophageal Cancer Surgery

Objective:Esophageal cancer is a common clinical digestive tract tumor,and its treatment is a comprehensive treatment based on surgery.Surgery usually requires a combination of tracheal intubation and intravenous anesthesia.Long-term clinical observations have found that some patients with esophageal cancer after surgery may delay the extraction of tracheal intubation for various reasons,requiring further mechanical ventilation.This will lead to prolonged hospital stays,increased treatment costs,increased risk of cross-infection and ventilator-related complications.This delays the patient’s recovery,which is contrary to today’s accelerated rehabilitation surgery philosophy.The current risk factors for delayed extubation in esophageal cancer have not been reported in the literature.Therefore,this article aims to study the risk factors associated with delayed extubation in patients with esophageal cancer,to guide interventions during perioperative period,to promote rapid postoperative recovery,shorten hospitalization time,reduce complications,improve clinical efficacy,and reduce the economic burden of patients.Methods:Retrospective analysis of the clinical data of 857 patients who underwent surgical treatment of esophageal cancer under general anesthesia from January 1,2009 to May 31,2018,the First Affiliated Hospital of Chengdu Medical College.Patients were divided into delayed extubation group(experimental group)and non-delay extubation group(control group)according to whether postoperative extubation time was longer than 6 hours.There were 59 patients in the experimental group,including 36 males and 23 females with an average age of 68.15±3.18 years;798 patients in the control group,617 males and 181 females.After the sample adjustment ratio(1:4),236 cases were randomly selected from the control group for statistical analysis,including 170 males and 66 females,with an average age of 63.08±7.28 years.Comparison of gender,age,preoperative comorbidity,body mass index(BMI),preoperative hemoglobin,albumin,left ventricular ejection fraction,renal function,liver function,operation time,surgical procedure,intraoperative infusion A number of related indicators,analysis of single-factor variables that may lead to postoperative delayed extubation.Logistic regression analysis of meaningful single-factor variables was performed to identify independent risk factors that may affect delayed extubation.Results:Of the 857 patients,a total of 59 patients had delayed extubation after surgery.Four of them died.The univariate variables included in the study that may lead to delayed extubation were age,body mass index(BMI),albumin,left ventricular ejection fraction,surgical procedure,and operative time(P<0.05).After statistical analysis of the collected data(logstic regression analysis),age(OR=1.393,95% CI: 1.163-1.668),BMI(OR=3.093,95% CI: 0.851-11.242),and operation time(OR)were found.=4.661,95% CI: 1.183-19.364)is an independent risk factor.