Journal of cardiothoracic and vascular anesthesia · 2025
Incidence of Vocal Cord Dysfunction in Cardiac Surgical versus Liver Transplantation Patients: A Retrospective Cohort Analysis.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Siddiqui Saher, Egorova Natalia, Wang Ryan, Williams Elbert, Levin Matthew, Kahn Ronald, Weiner Menachem
Аннотация
OBJECTIVES: This study aimed to compare vocal cord dysfunction (VCD) incidence between cardiac surgical and liver transplant (LT) patients and to assess associated anesthetic and surgical risk factors.
DESIGN: A retrospective cohort study.
SETTING: A single tertiary care hospital.
PARTICIPANTS: Patients.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Demographic, surgical, and anesthesia data were collected to assess the incidence and risk factors for VCD. Secondary outcomes included 30-day mortality, hospital length of stay, and postoperative pneumonia, and sepsis. VCD was identified via ICD-10 codes, CPT codes, or otolaryngology evaluations, with cases manually reviewed to confirm diagnosis and laterality. Statistical analyses included multivariate logistic regression models to identify risk factors, with results reported as odds ratios and 95% confidence intervals. In a cohort of 4,695 patients (4,262 cardiac and 433 LT), LT patients had longer surgical and ventilation times, higher reintubation rates, and worse postoperative outcomes, including pneumonia, sepsis, and mortality. VCD incidence was 1.8% in each group, with cardiac patients more likely to have left-sided VCD and LT patients exhibiting higher right or bilateral VCD. Logistic regression identified female sex, Asian race, and longer surgical times as significant risk factors for VCD, with similar findings in analyses restricted to cardiac patients.
CONCLUSIONS: Female sex, the Asian race, and longer surgical times were identified as significant risk factors for VCD, highlighting the need for targeted strategies to mitigate these risks, particularly in cardiac surgical patients.
DESIGN: A retrospective cohort study.
SETTING: A single tertiary care hospital.
PARTICIPANTS: Patients.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Demographic, surgical, and anesthesia data were collected to assess the incidence and risk factors for VCD. Secondary outcomes included 30-day mortality, hospital length of stay, and postoperative pneumonia, and sepsis. VCD was identified via ICD-10 codes, CPT codes, or otolaryngology evaluations, with cases manually reviewed to confirm diagnosis and laterality. Statistical analyses included multivariate logistic regression models to identify risk factors, with results reported as odds ratios and 95% confidence intervals. In a cohort of 4,695 patients (4,262 cardiac and 433 LT), LT patients had longer surgical and ventilation times, higher reintubation rates, and worse postoperative outcomes, including pneumonia, sepsis, and mortality. VCD incidence was 1.8% in each group, with cardiac patients more likely to have left-sided VCD and LT patients exhibiting higher right or bilateral VCD. Logistic regression identified female sex, Asian race, and longer surgical times as significant risk factors for VCD, with similar findings in analyses restricted to cardiac patients.
CONCLUSIONS: Female sex, the Asian race, and longer surgical times were identified as significant risk factors for VCD, highlighting the need for targeted strategies to mitigate these risks, particularly in cardiac surgical patients.