Publication:
Outcomes and risk factors of extubation failure: A multicenter study of the THAI surgical intensive care units (SICUs)

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Issued Date

2016

Resource Type

Article

File Type

application/pdf

ISSN

1252208

Other identifier(s)

2-s2.0-85012202205

Rights Holder(s)

Scopus

Bibliographic Citation

Journal of the Medical Association of Thailand. Vol 99, No.9 (2016), p.S136-S144

Suggested Citation

Buppha P., Kusumaphanyo C., Chittawatanarat K., The Thai-Sicu Study Group Outcomes and risk factors of extubation failure: A multicenter study of the THAI surgical intensive care units (SICUs). Journal of the Medical Association of Thailand. Vol 99, No.9 (2016), p.S136-S144. Retrieved from: https://hdl.handle.net/20.500.14740/5188

Title

Outcomes and risk factors of extubation failure: A multicenter study of the THAI surgical intensive care units (SICUs)

Author(s)

Buppha P.
 Kusumaphanyo C.
 Chittawatanarat K.
 The Thai-Sicu Study Group

Abstract

Objective: To identify risk factors associated with extubation failure (EF) in patients admitted to surgical ICUs (SICUs). Material and Method: Data were gathered during April 2011-January 2013 by collecting demographic, admission details, daily summary, nutritional profile, APACHE II scores, and discharge summary from patients admitted to SICUs among nine university hospitals. Exclusion criteria include pediatric patients, non-consent patients, multiple trauma, cardiovascular and thoracic, and neurosurgical patients. Data were collected to the endpoint of 28 days of admission. Morbidity and mortality were determined. Complications or adverse events that occurred during admission were detailed in separate record forms. Result: Of 4,652 patients, 2,890 were intubated. Among them, 2,749 were successfully extubated leaving 141 with extubation failure. Overall incidence of EF was 4.88% (with range from 1.41-7.33). Patient characteristics in EF groups were compared to successful groups. Advanced age, presence of congestive heart failure, vascular disease, COPD, emergency surgery, poor APACHE II and SOFA scores, and concurrent use of vasopressors, inotropes and sedatives were significant differences. The most common causes of EF were respiratory failure, inability to cough and laryngeal edema. Outcomes of EF included prolonged length of ICU stay [2 (IQR 1-5) vs. 11 (IQR 6-15) days] and hospital stay [16 (IQR 10-27) vs. 23 (IQR 15-33) days]. Patients with EF were at risk of 6-fold longer ICU stay than successful extubation. Adjusted odds ratio of age, congestive heart failure, emergency surgery, and SOFA score were identified with statistical significance to be risk factors of EF. Conclusion: EF can affect outcomes of ICU admission. Identifying the risk factors associated with EF will help reduce its incidence and improve ICU outcomes. © 2016, Medical Association of Thailand. All rights reserved.

Subject(s)

Hypertensive agent
 Inotropic agent
 Sedative agent
 Adult
 Age
 APACHE
 Article
 Chronic obstructive lung disease
 Congestive heart failure
 Emergency surgery
 Extubation failure
 Female
 Human
 Larynx edema
 Length of stay
 Major clinical study
 Male
 Mortality
 Multicenter study
 Pressure support ventilation
 Respiratory failure
 Respiratory tract intubation
 Risk factor
 Sequential Organ Failure Assessment Score
 Surgical intensive care unit
 Treatment failure
 Treatment outcome
 Vascular disease
 Aged
 Clinical trial
 Emergency
 Extubation
 Heart failure
 Intensive care unit
 Middle aged
 Organ dysfunction score
 Postoperative care
 Prospective study
 Thailand
 University hospital
 Adult
 Age Factors
 Aged
 Airway Extubation
 Emergencies
 Female
 Heart Failure
 Hospitals, University
 Humans
 Intensive Care Units
 Male
 Middle Aged
 Organ Dysfunction Scores
 Postoperative Care
 Prospective Studies
 Risk Factors
 Thailand

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URI

https://hdl.handle.net/20.500.14740/5188

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Scopus: Year 1983-2021

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