Evidence map›Paper›PMID 40194872›Full record

ArticleBMJ open2025

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

Yang Tian, Jiao Li, Guangjin Zhou, Mingya Wang, Yinyin Qu, Min Li, Jun Wang, Mao Xu, Shenglin Wang, Xiangyang Guo and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yang Tian *Department of Anesthesiology, Peking University Third Hospital, Beijing, China.ORCID http://orcid.org/0000-0002-6978-5673
Jiao Li *Department of Anesthesiology, Peking University Third Hospital, Beijing, China.ORCID http://orcid.org/0000-0003-0838-2544
Guangjin Zhou *Department of Radiology, Peking University Third Hospital, Beijing, China.
Mingya WangDepartment of Anesthesiology, Peking University Third Hospital, Beijing, China.
Yinyin QuDepartment of Anesthesiology, Peking University Third Hospital, Beijing, China.ORCID http://orcid.org/0000-0001-5919-8283
Min LiDepartment of Anesthesiology, Peking University Third Hospital, Beijing, China.
Jun WangDepartment of Anesthesiology, Peking University Third Hospital, Beijing, China.
Mao XuDepartment of Anesthesiology, Peking University Third Hospital, Beijing, China.
Shenglin WangDepartment of Orthopaedics, Peking University Third Hospital, Beijing, China.
Xiangyang GuoDepartment of Anesthesiology, Peking University Third Hospital, Beijing, China hanyongzheng@bjmu.edu.cn puthmzk@hsc.pku.edu.cn.
Yongzheng HanDepartment of Anesthesiology, Peking University Third Hospital, Beijing, China hanyongzheng@bjmu.edu.cn puthmzk@hsc.pku.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to investigate the incidence, risk factors and airway management of postoperative haematoma following anterior cervical spine surgery (ACSS).

designA retrospective nested case-control study.

settingA tertiary hospital in China.

participantsA total of 13 523 patients within a single-centre longitudinal ACSS cohort were identified from March 2013 to February 2022. Patients with postoperative haematoma after ACSS were enrolled as the haematoma group, and others in the cohort without haematoma were randomly selected as the non-haematoma 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 haematoma were included in a subgroup for analysis. PRIMARY OUTCOME MEASURES: Postoperative haematoma and difficult intubation prior to haematoma evacuation.

resultsThe incidence of postoperative haematoma out of all ACSS was 0.4% (55/13 523). A total of 275 patients were enrolled in the study, including 55 patients in the haematoma group and 220 patients in the non-haematoma group. Anterior cervical corpectomy and fusion (ACCF) (OR 2.459; 95% CI 1.302 to 4.642; p =0.006) and the maximum mean arterial pressure (MAP) during recovery (OR 1.030; 95% CI 1.003 to 1.058; p =0.028) were identified as independent risk factors for haematoma. In the subgroup analysis, 29% of patients with haematoma experienced difficult intubation, and retropharyngeal haematoma (OR 10.435; 95% CI 1.249 to 87.144; p =0.030) was identified as an independent risk factor for difficult intubation. Patients with haematoma had longer hospitalisation duration (p <0.001) and greater costs associated with their stay (p <0.001).

conclusionACCF and elevated maximum MAP during the recovery period were independent risk factors for postoperative haematoma following ACSS. Patients with post-ACSS haematoma are at high risk of a difficult airway, with retropharyngeal haematoma being strongly associated with challenging airway management. Postoperative haematoma was associated with longer hospitalisation duration and greater costs. TRIAL REGISTRATION NUMBER: China Clinical Trial Registry: ChiCTR2400086263.

Indexed as

Airway ManagementCervical VertebraeHematomaPostoperative ComplicationsAdultAgedCase-Control StudiesChinaFemaleHumansIncidenceIntubation, IntratrachealMaleMiddle AgedRetrospective StudiesRisk FactorsAnaesthesia in neurologyNeurosurgerySpine

Identifiers

PMID40194872
PMCPMC11977486

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.