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

研究成果: 雜誌貢獻文章

12 引文 斯高帕斯(Scopus)

摘要

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.
原文英語
頁(從 - 到)120-129
頁數10
期刊International Journal of Gerontology
4
發行號3
DOIs
出版狀態已發佈 - 九月 2010

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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    Chen, C. M., Chan, K. S., Fong, Y., Hsing, S. C., Cheng, A. C., Sung, M. Y., Su, 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