Factors Associated With 14-D Reintubation and Outcomes in Surgical Intensive Care Unit Patients

Area of Science:

• Critical Care Medicine
• Respiratory Therapy
• Surgical Outcomes

Background:

• Reintubation post-extubation is a significant complication in surgical intensive care units (SICUs).
• It often signifies patient deterioration and is linked to adverse outcomes.
• SICU-specific data on reintubation incidence and risk factors are limited.

Purpose of the Study:

• To determine the incidence and identify risk factors for reintubation after planned extubation in SICU patients.
• To analyze the clinical outcomes associated with reintubation.
• To evaluate the impact of preventive measures on reintubation rates.

Main Methods:

• Retrospective cohort study of adult postoperative patients undergoing planned extubation in two Taiwanese SICUs (Jan 2009-May 2024).
• Propensity score matching (1:4) was used to balance baseline characteristics.
• Multivariable logistic regression identified factors associated with reintubation; clinical outcomes were compared.

Main Results:

• The reintubation rate was 4.5% (501/11,194 patients).
• Independent risk factors included ER/ICU transfer, high SOFA scores, prolonged ventilation, vasopressor use, and specific lab abnormalities.
• Incentive spirometry and noninvasive ventilation were associated with reduced reintubation odds.

Conclusions:

• Reintubation in SICU patients is associated with prolonged ICU/hospital stays, increased mortality, and higher costs.
• Early identification of high-risk features is crucial for improving extubation readiness assessment.
• Targeted monitoring and preventive strategies are essential to mitigate reintubation complications.