Age is an important predictor of failed unplanned extubation

Chin Ming Chen, Khee Siang Chan, Yao Fong, Shu Chen Hsing, Ai Chin Cheng, Mei Yi Sung, Mei Yu Su, Kuo Chen Cheng

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background Unplanned extubation (UE) is a frequent complication following endotracheal intubation and can increase intensive care unit (ICU) stay and hospital expenditure. We investigated the incidence, outcome, and predictive factors of patients with failed UE (reintubation within 48 hours) in the adult ICU of a medical center in Taiwan. Methods We reviewed the medical records of patients with UE in ICUs from January 2004 through December 2007. The primary endpoint was factors predicting failed UE, especially in older patients (age ≥ 65 years). The second endpoint was the outcomes by age. Results There were 539 UEs, representing a rate of 3.6 for all mechanically ventilated patients, a failed UE rate of 48.2 (260/539) and a hospital mortality rate of 16.9 (91/539). In multivariate analyses, the factors predicting failed UE were: not being on a weaning trial (odds ratio, OR, 2.694), accidental extubation (OR, 2.232), older age (OR, 2.028), pulmonary cause of intubation (OR, 1.958), longer intubation time (OR, 1.002), and lower mean arterial pressure (OR, 0.980). Older patients had significant longer ICU and hospital stays than younger ones (15.5 vs. 12.1 days and 37.4 vs. 30.2 days, respectively, both p <0.05), higher hospital mortality (17.7 vs. 15.8), and higher hospital costs ($375,700 vs. $337,200 New Taiwan Dollars). Conclusion Older patients with failed UE had significantly longer ICU and hospital stays and tended to have higher hospital mortality and costs. Many factors predicted failed UE, including age. Physicians should consider age a risk factor for failed UE and adverse events.

Original languageEnglish
Pages (from-to)120-129
Number of pages10
JournalInternational Journal of Gerontology
Volume4
Issue number3
DOIs
Publication statusPublished - Sep 2010

Fingerprint

Intensive Care Units
Hospital Mortality
Length of Stay
Hospital Costs
Taiwan
Intubation
Intratracheal Intubation
Health Expenditures
Weaning
Medical Records
Arterial Pressure
Multivariate Analysis
Odds Ratio
Physicians
Lung
Mortality
Incidence

Keywords

  • aged
  • intensive care
  • intratracheal intubation
  • length of stay
  • mechanical ventilation
  • reintubation
  • unplanned extubation

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Chen, C. M., Chan, K. S., Fong, Y., Hsing, S. C., Cheng, A. C., Sung, M. Y., ... Cheng, K. C. (2010). Age is an important predictor of failed unplanned extubation. International Journal of Gerontology, 4(3), 120-129. https://doi.org/10.1016/S1873-9598(10)70035-1

Age is an important predictor of failed unplanned extubation. / Chen, Chin Ming; Chan, Khee Siang; Fong, Yao; Hsing, Shu Chen; Cheng, Ai Chin; Sung, Mei Yi; Su, Mei Yu; Cheng, Kuo Chen.

In: International Journal of Gerontology, Vol. 4, No. 3, 09.2010, p. 120-129.

Research output: Contribution to journalArticle

Chen, CM, Chan, KS, Fong, Y, Hsing, SC, Cheng, AC, Sung, MY, Su, MY & Cheng, KC 2010, 'Age is an important predictor of failed unplanned extubation', International Journal of Gerontology, vol. 4, no. 3, pp. 120-129. https://doi.org/10.1016/S1873-9598(10)70035-1
Chen, Chin Ming ; Chan, Khee Siang ; Fong, Yao ; Hsing, Shu Chen ; Cheng, Ai Chin ; Sung, Mei Yi ; Su, Mei Yu ; Cheng, Kuo Chen. / Age is an important predictor of failed unplanned extubation. In: International Journal of Gerontology. 2010 ; Vol. 4, No. 3. pp. 120-129.
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abstract = "Background Unplanned extubation (UE) is a frequent complication following endotracheal intubation and can increase intensive care unit (ICU) stay and hospital expenditure. We investigated the incidence, outcome, and predictive factors of patients with failed UE (reintubation within 48 hours) in the adult ICU of a medical center in Taiwan. Methods We reviewed the medical records of patients with UE in ICUs from January 2004 through December 2007. The primary endpoint was factors predicting failed UE, especially in older patients (age ≥ 65 years). The second endpoint was the outcomes by age. Results There were 539 UEs, representing a rate of 3.6 for all mechanically ventilated patients, a failed UE rate of 48.2 (260/539) and a hospital mortality rate of 16.9 (91/539). In multivariate analyses, the factors predicting failed UE were: not being on a weaning trial (odds ratio, OR, 2.694), accidental extubation (OR, 2.232), older age (OR, 2.028), pulmonary cause of intubation (OR, 1.958), longer intubation time (OR, 1.002), and lower mean arterial pressure (OR, 0.980). Older patients had significant longer ICU and hospital stays than younger ones (15.5 vs. 12.1 days and 37.4 vs. 30.2 days, respectively, both p <0.05), higher hospital mortality (17.7 vs. 15.8), and higher hospital costs ($375,700 vs. $337,200 New Taiwan Dollars). Conclusion Older patients with failed UE had significantly longer ICU and hospital stays and tended to have higher hospital mortality and costs. Many factors predicted failed UE, including age. Physicians should consider age a risk factor for failed UE and adverse events.",
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AU - Chen, Chin Ming

AU - Chan, Khee Siang

AU - Fong, Yao

AU - Hsing, Shu Chen

AU - Cheng, Ai Chin

AU - Sung, Mei Yi

AU - Su, Mei Yu

AU - Cheng, Kuo Chen

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N2 - Background Unplanned extubation (UE) is a frequent complication following endotracheal intubation and can increase intensive care unit (ICU) stay and hospital expenditure. We investigated the incidence, outcome, and predictive factors of patients with failed UE (reintubation within 48 hours) in the adult ICU of a medical center in Taiwan. Methods We reviewed the medical records of patients with UE in ICUs from January 2004 through December 2007. The primary endpoint was factors predicting failed UE, especially in older patients (age ≥ 65 years). The second endpoint was the outcomes by age. Results There were 539 UEs, representing a rate of 3.6 for all mechanically ventilated patients, a failed UE rate of 48.2 (260/539) and a hospital mortality rate of 16.9 (91/539). In multivariate analyses, the factors predicting failed UE were: not being on a weaning trial (odds ratio, OR, 2.694), accidental extubation (OR, 2.232), older age (OR, 2.028), pulmonary cause of intubation (OR, 1.958), longer intubation time (OR, 1.002), and lower mean arterial pressure (OR, 0.980). Older patients had significant longer ICU and hospital stays than younger ones (15.5 vs. 12.1 days and 37.4 vs. 30.2 days, respectively, both p <0.05), higher hospital mortality (17.7 vs. 15.8), and higher hospital costs ($375,700 vs. $337,200 New Taiwan Dollars). Conclusion Older patients with failed UE had significantly longer ICU and hospital stays and tended to have higher hospital mortality and costs. Many factors predicted failed UE, including age. Physicians should consider age a risk factor for failed UE and adverse events.

AB - Background Unplanned extubation (UE) is a frequent complication following endotracheal intubation and can increase intensive care unit (ICU) stay and hospital expenditure. We investigated the incidence, outcome, and predictive factors of patients with failed UE (reintubation within 48 hours) in the adult ICU of a medical center in Taiwan. Methods We reviewed the medical records of patients with UE in ICUs from January 2004 through December 2007. The primary endpoint was factors predicting failed UE, especially in older patients (age ≥ 65 years). The second endpoint was the outcomes by age. Results There were 539 UEs, representing a rate of 3.6 for all mechanically ventilated patients, a failed UE rate of 48.2 (260/539) and a hospital mortality rate of 16.9 (91/539). In multivariate analyses, the factors predicting failed UE were: not being on a weaning trial (odds ratio, OR, 2.694), accidental extubation (OR, 2.232), older age (OR, 2.028), pulmonary cause of intubation (OR, 1.958), longer intubation time (OR, 1.002), and lower mean arterial pressure (OR, 0.980). Older patients had significant longer ICU and hospital stays than younger ones (15.5 vs. 12.1 days and 37.4 vs. 30.2 days, respectively, both p <0.05), higher hospital mortality (17.7 vs. 15.8), and higher hospital costs ($375,700 vs. $337,200 New Taiwan Dollars). Conclusion Older patients with failed UE had significantly longer ICU and hospital stays and tended to have higher hospital mortality and costs. Many factors predicted failed UE, including age. Physicians should consider age a risk factor for failed UE and adverse events.

KW - aged

KW - intensive care

KW - intratracheal intubation

KW - length of stay

KW - mechanical ventilation

KW - reintubation

KW - unplanned extubation

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