Abstract：
OBJECTIVE: To observe the occurrence of postanaesthetic respiratory complications and to determine their prevalence and risk factors in dogs undergoing brachycephalic obstructive airway syndrome surgery.
METHODS: Data from 199 clinical records were retrospectively analysed. Univariable logistic regression followed by multivariable logistic regression was used to identify associations between the dependent variables (set as the postoperative respiratory complications observed in the study dogs) and various independent covariates. The quality of model-fit was assessed using the likelihood ratio test. P≤0.05 was considered statistically significant.
RESULTS: Four postoperative respiratory complications were observed: hypoxaemia (n=10/199; 5%), dyspnoea requiring tracheal re-intubation (n=13/199, 7%), dyspnoea requiring tracheostomy (n=10/199, 5%) and aspiration pneumonia (n=12/199, 6%). Univariable logistic regression showed an association between postoperative aspiration pneumonia and increasing body condition score and American Society of Anaesthesiology classification; however, when these covariates were evaluated in the multivariable model significance was not maintained. Risk factors for tracheostomy were preoperative and postoperative aspiration pneumonia (odds ratio: 9.52, 95% confidence interval: 1.56 to 57.93) and increasing brachycephalic obstructive airway syndrome grade (odds ratio: 4.65, 95% confidence interval: 0.79 to 27.50).
CONCLUSIONS: High brachycephalic obstructive airway syndrome grade and aspiration pneumonia, either developing peri-operatively or as pre-existing condition, may represent risk factors for postoperative tracheostomy. Preoperative diagnosis of aspiration pneumonia may further increase the risk of postoperative complications.
METHODS: Data from 199 clinical records were retrospectively analysed. Univariable logistic regression followed by multivariable logistic regression was used to identify associations between the dependent variables (set as the postoperative respiratory complications observed in the study dogs) and various independent covariates. The quality of model-fit was assessed using the likelihood ratio test. P≤0.05 was considered statistically significant.
RESULTS: Four postoperative respiratory complications were observed: hypoxaemia (n=10/199; 5%), dyspnoea requiring tracheal re-intubation (n=13/199, 7%), dyspnoea requiring tracheostomy (n=10/199, 5%) and aspiration pneumonia (n=12/199, 6%). Univariable logistic regression showed an association between postoperative aspiration pneumonia and increasing body condition score and American Society of Anaesthesiology classification; however, when these covariates were evaluated in the multivariable model significance was not maintained. Risk factors for tracheostomy were preoperative and postoperative aspiration pneumonia (odds ratio: 9.52, 95% confidence interval: 1.56 to 57.93) and increasing brachycephalic obstructive airway syndrome grade (odds ratio: 4.65, 95% confidence interval: 0.79 to 27.50).
CONCLUSIONS: High brachycephalic obstructive airway syndrome grade and aspiration pneumonia, either developing peri-operatively or as pre-existing condition, may represent risk factors for postoperative tracheostomy. Preoperative diagnosis of aspiration pneumonia may further increase the risk of postoperative complications.
摘要：
目的：观察麻醉后呼吸道并发症的发生情况，并确定其患病率和危险因素。
方法：回顾性分析来自199份临床记录的数据。使用单变量逻辑回归和多变量逻辑回归来鉴定因变量(设定为在研究犬中观察到的术后呼吸系统并发症)与各种独立协变量之间的关联。使用似然比检验评估模型拟合的质量。P≤0.05被认为具有统计学意义。
结果：观察到四种术后呼吸系统并发症：低氧血症（n=10/199；5％），需要气管重新插管的呼吸困难（n=13/199，7%），需要气管切开术的呼吸困难（n=10/199，5％）和吸入性肺炎（n=12/199，6％）。单变量logistic回归显示术后吸入性肺炎与增加的身体状况评分和美国麻醉学会分类之间存在关联；然而，当在多变量模型中评估这些协变量时,显著性未得到维持.气管切开术的危险因素为术前和术后吸入性肺炎（比值比：9.52，95%置信区间：1.56~57.93）和短脑阻塞性气道综合征分级增加（比值比：4.65，95%置信区间：0.79~27.50）。
结论：高度短脑阻塞性气道综合征和吸入性肺炎，要么发展为围手术期，要么作为预先存在的疾病，可能是术后气管造口术的危险因素。术前诊断吸入性肺炎可能进一步增加术后并发症的风险。
方法：回顾性分析来自199份临床记录的数据。使用单变量逻辑回归和多变量逻辑回归来鉴定因变量(设定为在研究犬中观察到的术后呼吸系统并发症)与各种独立协变量之间的关联。使用似然比检验评估模型拟合的质量。P≤0.05被认为具有统计学意义。
结果：观察到四种术后呼吸系统并发症：低氧血症（n=10/199；5％），需要气管重新插管的呼吸困难（n=13/199，7%），需要气管切开术的呼吸困难（n=10/199，5％）和吸入性肺炎（n=12/199，6％）。单变量logistic回归显示术后吸入性肺炎与增加的身体状况评分和美国麻醉学会分类之间存在关联；然而，当在多变量模型中评估这些协变量时,显著性未得到维持.气管切开术的危险因素为术前和术后吸入性肺炎（比值比：9.52，95%置信区间：1.56~57.93）和短脑阻塞性气道综合征分级增加（比值比：4.65，95%置信区间：0.79~27.50）。
结论：高度短脑阻塞性气道综合征和吸入性肺炎，要么发展为围手术期，要么作为预先存在的疾病，可能是术后气管造口术的危险因素。术前诊断吸入性肺炎可能进一步增加术后并发症的风险。
