Incidence, risk factors and airway management of postoperative hematoma following anterior cervical spine surgery: a retrospective nested case–control study

Description

The aim of this study was to investigate the incidence, risk factors and airway management of postoperative hematoma (HT) following anterior cervical spine surgery (ACSS). Design: A retrospective nested case–control study. A longitudinal ACSS cohort was identified from March 2013 to February 2022. Patients with postoperative HT after ACSS were enrolled as the HT group, and others in the cohort without HT were randomly selected as the non-HT group by individually matching at a ratio of 4:1. Subsequently, patients with HT were included in a subgroup for analysis.

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Patients with postoperative HT after ACSS were enrolled as the HT group, and others in the cohort without HT were randomly selected as the non-HT group by individually matching with the same operator, same gender, same surgery year, and similar age (±5 years) at a ratio of 4:1. Subsequently, patients with HT were included in a subgroup for analysis. The general characteristics, disease-related factors, surgical factors, and anesthetic factors of the two groups were collected. Differences between the two groups for continuous variables were analyzed using an independent samples t-test (for data with a normal distribution) or a Mann-Whitney U test (for data without a normal distribution). Categorical data were expressed as percentages and analyzed for differences using the chi-square test or Fisher's exact test. A binary logistic regression model was applied to identify multivariate variables, utilizing the Backward-Wald method for variable selection. Odds ratios (OR) and 95% confidence intervals (CI) were used to quantify the strength of associations. The accuracy of diagnostic tests was assessed using receiver operating characteristic curves and the area under the curve (AUC). Statistical analyses were performed using SPSS version 26.0, with all tests being two-tailed, and P < 0.05 indicating statistical significance of differences.

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