Factors associated with an increased risk of mechanical ventilation lasting over 48 hours after abdominal surgery at Maharat Nakhonratchasima Hospital.

Abstract

Prolonged postoperative mechanical ventilation more than 48 hours is a major problem associated with increased postoperative mortality and longer hospital stays. Objective To investigate factors that increase the risk of prolonged mechanical ventilation (>48 hours) in postoperative abdominal surgery patients admitted to the surgical and obstetric-gynecologic intensive care unit at Maharaj Nakhon Ratchasima Hospital. Methods A retrospective case-control study. Data were collected from patients aged 18 years and older who were admitted to the intensive care unit after open abdominal surgery at Maharaj Nakhon Ratchasima Hospital between 2021 and 2024, for a total of 350 cases. Results Among 350 postoperative open abdominal surgery patients who required mechanical ventilation, factors associated with postoperative ventilation >48 hours included age >65 years, presence of preoperative respiratory symptoms, emergency surgery, BUN >20 mg/dL, creatinine >1.10 mg/dL, serum albumin  <3 g/dL, operative time >180 minutes, and duration of anesthesia >200 minutes. Multivariate logistic regression analysis identified emergency surgery, preoperative respiratory symptoms, and low serum albumin as independent risk factors for postoperative mechanical ventilation >48 hours. Conclusion Emergency surgery, preoperative respiratory symptoms, and low serum albumin are associated with prolonged mechanical ventilation (>48 hours) after open abdominal surgery.