Objective
We aimed to determine the incidence, risk factors, and outcomes of unplanned
extubation among adult patients.
Methods
We conducted a prospective cohort study of adult intubated patients admitted
to the charity wards of a government tertiary teaching hospital in the
Philippines. Patients managed in both intensive care and nonintensive care
settings were included. Patients were followed-up until discharge or until
seven days postextubation.
Results
The outcomes of the 191 included patients were planned extubation (35%),
unplanned extubation (19%), death (39%), and discharge against advice (7%).
Competing risk regression showed that male sex (Crude OR: 2.25, 95%CI: 1.10
- 4.63) and age (Crude OR 0.976, 95%CI: 0.957 - 0.996) were significant
baseline factors. The night shift (Crude OR: 24.6, 95%CI: 2.87 - 211) was
also consistently associated with more unplanned extubations. Among
postextubation outcomes, reintubation (unplanned extubation: 61.1%
versus
planned extubation: 25.4%), acute respiratory
failure (unplanned extubation: 38.9%
versus
planned
extubation: 17.5%), and cardiovascular events (unplanned extubation: 8.33%
versus
planned extubation: 1.49%) occurred
significantly more often among the unplanned extubation patients. Admission
in an intensive care unit was not associated with a lower risk of unplanned
extubation (Crude OR 1.15, 95%CI: 0.594 - 2.21).
Conclusion
Many intubated patients had unplanned extubation. Patients admitted in
nonintensive care unit settings did not have significantly higher odds of
unplanned extubation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.