A case-control study on predictors and outcomes of unplanned extubation in mechanically ventilated critically ill patients
Eunok Kwon, PhD, RN, CCNS; Kyung Sook Choi, PhD, RN
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Session presented on Friday, July 25, 2014:
Purpose: To find out predictors & outcomes of unplanned extubation in mechanically ventilated critically ill patients.
Methods: Researcg design is a case-control study over 3 years period from January 1, 2010 through December 31, 2012. Settings is A 62-beds medical & surgical intensive care unit of 1800 beds tertiary hospital. Data were retrospectively collected from electronic medical records. A total 230 episodes of deliberate unplanned extubation in 242 patients from 41,207 mechanically ventilated patients for 3 years (frequency 0.53%). 460 episodes in 460 patients with planned extubation age, gender & diagnosis-matched controls were analyzed in this case-control study.
Results: Predictors associated with unplanned extubation include better motor response (OR 1.3), admission route via ER (OR 1.8), higher APACHE IIscore (1.061), mode of mechanical ventilation (CPAP, PSV: OR4.1, SIMV:3.0), peripheral O2 saturation (OR:0.9), heart rate (OR: 1.0), respiration rate (OR:1.0), pain (OR:0.3), agitation (OR:9.0), delirium (OR:11.6), night shift (OR:6.0) and morning care time (OR:0.5). The patients' & organizational outcomes of unplanned extubation were reintubation (OR;85.66), a poor discharge result (OR:0.2), a longer length of stay in the ICU (adj R-square:7%) and a longer length of stay in the hospital (adj R-square:4.3%).
Conclusion: Delirium, agitation, ventilation mode and night shift are high predictive factors of unplanned extubation. The outcomes of unplanned extubation were increasing reintubation, a poor patient outcome at the time of discharge and poor organizational outcome including longer length of stay in the ICU and hospital.
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong
Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository.
|Review Type||Abstract Review Only: Reviewed by Event Host|
Easy Guide to Nursing Research;
Evidence Based Nursing
|Name||25th International Nursing Research Congress|
|Host||Sigma Theta Tau International|
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