Analysis Of Risk Factors For Delayed Extubation After Heart Valve Surgery

Objective: Heart Valvular disease is currently the most common disease in cardiac surgery.In recent years,with the aging trend of the population,the incidence of valvular disease has also increased day by day,and its treatment is mainly based on surgical treatment,All operations require endotracheal intubation anesthesia.Delayed removal of the endotracheal tube after surgery due to various reasons will increase the ICU stay time,hospitalization costs,and the risk of complications such as respiratory infections.This study used a retrospective approach to explore the risk factors that affect the delayed extubation of patients undergoing heart valve surgery,so as to guide clinical perioperative management and take intervention measures to promote early recovery of patients.Methods:In this study,a total of 394 patients undergoing heart valve surgery were collected from the Department of Cardiac Surgery,the First Affiliated Yijishan Hospital of Wannan Medical College,from January 1,2019 to December 31,2020.in a retrospective analysis,including single and double Valve replacement or plasty,collecting perioperative data of these patients,According to the postoperative extubation time,they were divided into normal extubation group(extubation time <24h)and delayed extubation group(extubation time>24h).Among them,there were 284 cases in the normal extubation group,154 males and 130 females.110 patients in the delayed extubation group,53 males and 57 females,Collect preoperative data of the two groups of patients: age,gender,BMI,preoperative complications(hypertension,diabetes,hyperlipidemia,history of cerebral infarction,COPD),preoperative cardiac function(grade IV),preoperative renal function,Left ventricular ejection fraction,Preoperative BNP,left atrium and left ventricular diameter,intraoperative data: extracorporeal circulation time,aortic block time,operation time and intraoperative blood transfusion volume and other related indicators,The chi-square test,t-test or u-test is used to screen out the univariate variables that are meaningful for delayed extubation after surgery,and then the meaningful univariate variables are substituted into the logistic regression analysis model to conclude that it may affect the delayed extubation of the heart valve.Independent risk factors for management.Results:Among the 294 patients,110 patients in the delayed extubation group,the single factors that may cause delayed extubation are: age,cardiopulmonary bypass time,aortic block time,operation time,blood transfusion volume,preoperative renal function,preoperative Heart function,COPD.Bringing these univariate variables into the logistic regression analysis,the independent risk factors are: age(OR=1.064 95CI: 1.027,1.101),preoperative cardiac function(grade IV)(OR=5.872 95CI: 2.390 14.427)),preoperative renal function(OR=8.001,95CI=1.564 40.936),cardiopulmonary bypass time(OR=1.036,95CI: 1.026 1.047),blood transfusion(OR=1.001,95CI: 1.001 1.002),Previous history of cardiac surgery(OR=2.001,95CI:1.532 3.987).Conclusion: Age,preoperative cardiac function(grade IV),preoperative renal function,cardiopulmonary bypass time,Previous history of cardiac surgery,and blood transfusion are independent risk factors that affect delayed extubation after heart valve surgery.