Perioperative outcomes in patients with chronic respiratory failure dependent on home ventilation - a retrospective cohort study.

Authors

Jan De Mey, Lauren Heyman, Luc De Baerdemaeker, Pieter Depuydt, Eric Derom

Published in

Acta clinica Belgica. Pages 1-8. Aug 02, 2026. Epub Aug 02, 2026.

Abstract

Due to increased life expectancy, patients with chronic respiratory failure treated with home ventilation have an increasing likelihood of requiring surgery in their lifetime. Evidence on the safety and feasibility of surgery in this population is scarce.
Retrospective analysis of all surgical procedures under general anaesthesia in patients included in the chronic home ventilation registry at Ghent University Hospital.
Between 1 October 2006 and 1 March 2022, 128 surgical procedures were performed on 53 (female: 25) patients with a median age of 52 yr, BMI of 25 kg/m², Charlson Comorbidity Index of 2 and FVC of 1.12 L (34%). 21 patients were ventilated via tracheostomy. The most common cause of respiratory failure was neuromuscular disease and tetraplegia (28 patients). Most procedures were minor (e.g. tracheostomy revisions), but 30 non-elective or emergency procedures (including 7 laparotomies) were registered. Respiratory complications occurred in 25 procedures (19%) and were associated with length of stay (p < 0.001) and hospital mortality (p = 0.029). Four patients (8%) died, all after emergency surgery, with one death deemed not attributable to the underlying respiratory failure (intracerebral haemorrhage). The ARISCAT score (median: 19; range: 0-86) was significantly associated with respiratory complications, length of stay, and hospital mortality (all p < 0.05).
Surgery is feasible in chronically ventilated patients, though the risk of respiratory complications and death after surgery, particularly if non-elective, is not negligible. The ARISCAT score was associated with outcomes and appears to be a valuable tool for risk assessment in this population.

PMID:
42543028
Bibliographic data and abstract were imported from PubMed on 03 Aug 2026.

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