Prediction of Postoperative Sore Throat in Patients After Day-case Surgery With General Anesthesia: A Retrospective Study.

ABSTRACT

PURPOSE: Postoperative sore throat (POST) is a major complaint after day-case surgery. The objectives of this study were to investigate the risk factors for POST and develop a stratified nursing model for POST after day-case surgery. DESIGN: This case-control study was conducted at Department of Anesthesiology of 1st Affiliated Hospital of Wenzhou Medical University in Wenzhou, Zhejiang, China. METHODS: Anesthesia records and postanesthesia care files of adult patients undergoing day-case surgery with general anesthesia were reviewed. The primary outcome was the incidence of POST at 24 hours after day-case surgery or before discharge within 24 hours. Multivariate logistics regression was used to identify risk factors for POST. A nomogram was created to predict the probability of POST after day-case surgery. FINDINGS: A total of 9,312 records were retrieved from June 1, 2021 to April 30, 2022, including 8,499 files in the training group and 813 files in the validation group. One thousand five hundred and twenty-five cases in the training group experienced POST. The independent risk factors for POST included thyroid surgery (odds ratios [OR] = 22.42, 95% confidence intervals [CI] 18.45 to 27.25), shorter thyromental distance (OR = 1.18, 95% CI 1.06 to 1.30), smaller neck circumference (OR = 1.09, 95% CI 1.06 to 1.11), duration of anesthesia (OR = 1.13, 95% CI 1.04 to 1.22), female (OR = 1.66, 95% CI 1.41 to 1.96), age (OR = 0.99, 95% CI 0.99 to 1.00) and the presence of bloody sputum (OR = 8.33, 95% CI 6.53 to 10.63). A nomogram that involved five factors was established to predict the probability of POST after day-case surgery. The area under the receiver operating characteristic curve in the training and validation groups was 0.77 and 0.81, respectively. The calibration curve demonstrated good consistency between the actual POST and the predicted probability. CONCLUSIONS: The following variables are independently associated with POST thyroid surgery, age approaching to 40 years old, female, shorter thyromental distance and smaller neck circumference, longer duration of anesthesia, and the presence of bloody sputum. A novel stratified nursing model is feasible for predicting the probability of POST.