Risk factors and treatment of difficult intubation during retropharyngeal hematoma evacuation following anterior cervical spine surgery: a retrospective study

The purpose of this retrospective study was to investigate the incidence and risk factors for DI and airway management in RH evacuation following ACSS. A series of 40 consecutive patients who developed RH following ACSS were retrospectively identified at Peking University Third Hospital from March 2010 to March 2023. Patients were categorized into the DI group or no-DI group. Demographic, clinical symptom, and airway assessment data were recorded to identify risk factors for DI.
The study findings revealed a significantly higher proportion of patients with Class III & IV AAO in the DI group (64.3%) compared to the no-DI group (19.2%) (P=0.007). Moreover, the differences in the time interval between symptom onset and airway intervention was statistically significant between the DI group (2.0 [2.6] hours) and the no-DI group (1.0 [0.6] hours) (P=0.002). There were significant differences between the two groups in terms of the retention time of the tracheal catheter and duration of stay in the ICU (P<0.001).
Binary multivariate logistic regression (Enter) analyses identified one independent correlative factor: Class III & IV AAO. The OR and 95% CI of the indicator were 5.369 (1.054-27.342).