TY - JOUR
T1 - A retrospective analysis of the incidence and determinants of self-extubation in a tertiary care surgical intensive care unit
AU - Ali, Muhammad Asghar
AU - Rashid, Saima
AU - Siddiqui, Khalid Maudood
AU - Yousuf, Muhammad Saad
N1 - Publisher Copyright:
© 2023 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.
PY - 2023/6
Y1 - 2023/6
N2 - Background & Objective: Self-extubation is reported as one of the most common adverse events in the adult intensive care units worldwide. We aimed to find out the incidence and determinants of self-extubation in surgical intensive care unit of our tertiary care hospital. Methodology: It was retrospective analysis of the data acquired from the hospital databases, about the patients who self-extubated during admission to surgical intensive care unit (SICU) of Aga Khan University Hospital, Karachi, Pakistan, during six calendar years, from January 01, 2010, through December 31, 2016. Data collection form was used to collect personal details, drugs used for sedation, sedation agitation score, pain score, nurse-patient ratio and the use of any restraint at the time of extubation. SPSS was used to analyze data applying the central limit theorem to calculate the mean and standard deviation for quantitative variables and the Chi-square test was conducted using a P < 0.05 for qualitative variables. Multivariate logistic regression analysis was performed to identify the independent risk factors for self-extubation Results: A total of 618 patients were admitted to the SICU who required mechanical ventilation during the study period. An overall 2.1% incidence of self-extubation was calculated with a documented thirteen self-extubation episodes. The mean age of patients was 38.46 ± 16.97 y with majority of them being males. Most, 9 (69.2%), of the patients were not restrained at the time of self-extubation. Nurse to patient ratio was 1:1. Majority of patients 7 (53.8%) were not on any sedative drug infusion and the mean sedation agitation score at that time was 4.46 ± 2.02 while mean pain score was 5.31 ± 2.72. Reintubation was performed in 10 (76.9%) of the patients, who had self-extubated. Conclusion: This study revealed that the incidence of self-extubation was 2.1% in SICU_and there was strong correlation between absent physical restraint and self-extubation incidence during the weaning period.
AB - Background & Objective: Self-extubation is reported as one of the most common adverse events in the adult intensive care units worldwide. We aimed to find out the incidence and determinants of self-extubation in surgical intensive care unit of our tertiary care hospital. Methodology: It was retrospective analysis of the data acquired from the hospital databases, about the patients who self-extubated during admission to surgical intensive care unit (SICU) of Aga Khan University Hospital, Karachi, Pakistan, during six calendar years, from January 01, 2010, through December 31, 2016. Data collection form was used to collect personal details, drugs used for sedation, sedation agitation score, pain score, nurse-patient ratio and the use of any restraint at the time of extubation. SPSS was used to analyze data applying the central limit theorem to calculate the mean and standard deviation for quantitative variables and the Chi-square test was conducted using a P < 0.05 for qualitative variables. Multivariate logistic regression analysis was performed to identify the independent risk factors for self-extubation Results: A total of 618 patients were admitted to the SICU who required mechanical ventilation during the study period. An overall 2.1% incidence of self-extubation was calculated with a documented thirteen self-extubation episodes. The mean age of patients was 38.46 ± 16.97 y with majority of them being males. Most, 9 (69.2%), of the patients were not restrained at the time of self-extubation. Nurse to patient ratio was 1:1. Majority of patients 7 (53.8%) were not on any sedative drug infusion and the mean sedation agitation score at that time was 4.46 ± 2.02 while mean pain score was 5.31 ± 2.72. Reintubation was performed in 10 (76.9%) of the patients, who had self-extubated. Conclusion: This study revealed that the incidence of self-extubation was 2.1% in SICU_and there was strong correlation between absent physical restraint and self-extubation incidence during the weaning period.
KW - Mechanical ventilation
KW - Reintubation
KW - Sedation
KW - Self-extubation
KW - Surgical Intensive Care Unit
KW - Tertiary Care Hospital
UR - http://www.scopus.com/inward/record.url?scp=85165437681&partnerID=8YFLogxK
U2 - 10.35975/apic.v27i3.2231
DO - 10.35975/apic.v27i3.2231
M3 - Article
AN - SCOPUS:85165437681
SN - 1607-8322
VL - 27
SP - 360
EP - 363
JO - Anaesthesia, Pain and Intensive Care
JF - Anaesthesia, Pain and Intensive Care
IS - 3
ER -