A Case-Control Study on Predictors and Outcomes of Unplanned Extubation in Mechanically Ventilated Critically Ill Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/335297
Category:
Full-text
Type:
Presentation
Title:
A Case-Control Study on Predictors and Outcomes of Unplanned Extubation in Mechanically Ventilated Critically Ill Patients
Other Titles:
Global Research in the Acute Care Setting
Author(s):
Kwon, Eunok; Choi, Kyung Sook
Lead Author STTI Affiliation:
Non-member
Author Details:
Eunok Kwon, PhD, RN, CCNS, wan3535@snuh.org; Kyung Sook Choi, PhD, RN
Abstract:
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.
Keywords:
meta analysis; Easy guide to nursing research; Evidence based nursing
Repository Posting Date:
17-Nov-2014
Date of Publication:
17-Nov-2014 ; 17-Nov-2014
Other Identifiers:
INRC14B09
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleA Case-Control Study on Predictors and Outcomes of Unplanned Extubation in Mechanically Ventilated Critically Ill Patientsen
dc.title.alternativeGlobal Research in the Acute Care Settingen
dc.contributor.authorKwon, Eunoken
dc.contributor.authorChoi, Kyung Sooken
dc.contributor.departmentNon-memberen
dc.author.detailsEunok Kwon, PhD, RN, CCNS, wan3535@snuh.org; Kyung Sook Choi, PhD, RNen
dc.identifier.urihttp://hdl.handle.net/10755/335297-
dc.description.abstractSession 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.en
dc.subjectmeta analysisen
dc.subjectEasy guide to nursing researchen
dc.subjectEvidence based nursingen
dc.date.available2014-11-17T13:49:06Z-
dc.date.issued2014-11-17-
dc.date.issued2014-11-17en
dc.date.accessioned2014-11-17T13:49:06Z-
dc.conference.date2014en
dc.conference.name25th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationHong Kongen
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen
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