TABLE 4.
Factors Associated With Reintubation Within 48 Hours After a Planned Extubation
| Characteristics | Unadjusteda
|
Adjustedb
|
||||
|---|---|---|---|---|---|---|
| OR | 95% CI | p | AOR | 95% CI | p | |
| Male sex | 1.06 | 0.69, 1.62 | 0.79 | |||
|
| ||||||
| Neonate (< 30 d) at hospital admission | 3.36 | 2.21, 5.12 | < 0.0001 | 1.64 | 0.82, 3.31 | 0.16 |
|
| ||||||
| Weight-for-age z-score at hospital admission | 1.01 | 0.96, 1.07 | 0.65 | |||
|
| ||||||
| Any chromosomal anomaly, syndrome, or extracardiac anomaly | 1.25 | 0.80, 1.97 | 0.33 | |||
|
| ||||||
| Airway anomaly | 2.76 | 0.83, 9.22 | 0.098 | 2.74 | 0.90, 8.39 | 0.08 |
|
| ||||||
| Hospitalization type | ||||||
| Surgical | 0.58 | 0.30, 1.12 | 0.11 | |||
| Medical | Ref | |||||
|
| ||||||
| STAT category | 0.0003 | 0.51 | ||||
| Nonsurgical (i.e., medical) | 2.33 | 1.16, 4.65 | 0.02 | 1.41 | 0.62, 3.23 | 0.42 |
| 1–3 | Ref | Ref | ||||
| 4 or 5 | 2.82 | 1.81, 4.40 | < 0.0001 | 1.35 | 0.73, 2.47 | 0.34 |
|
| ||||||
| Reason for the initial CICU encounter | ||||||
| Postoperative cardiac surgery | Ref | Ref | ||||
| All others | 3.42 | 2.21, 5.30 | < 0.0001 | 1.56 | 0.74, 3.27 | 0.24 |
|
| ||||||
| Time of the day of the extubation | ||||||
| Daytime (7:00 AM–5:00 PM) | 0.96 | 0.56, 1.67 | 0.90 | |||
| Off hours (5:01 AM–6:59PM) | Ref | |||||
|
| ||||||
| Day of the week of the extubation | ||||||
| Weekday (Monday–Friday) | Ref | |||||
| Weekend (Saturday/Sunday) | 1.13 | 0.53, 2.39 | 0.75 | |||
|
| ||||||
| Duration of mechanical ventilation, hr | 0.001 | 0.01 | ||||
| < 9.6 hr (median) | Ref | Ref | ||||
| 9.6–44.1 hr | 3.22 | 1.89, 5.49 | < 0.0001 | 2.81 | 1.32, 6.00 | 0.01 |
| ≥ 44.1 hr (75th percentile) | 4.54 | 2.70, 7.64 | < 0.0001 | 2.54 | 1.14, 5.64 | 0.02 |
|
| ||||||
| Extubation in CICU | 1.97 | 0.97, 4.00 | 0.06 | 0.54 | 0.20, 1.47 | 0.23 |
|
| ||||||
| Final airway type used during mechanical ventilation course | ||||||
| Oral | 1.58 | 0.61, 4.14 | 0.35 | |||
| Nasal | Ref | |||||
|
| ||||||
| Diaphragm paralysis during the hospitalization | 2.13 | 0.54, 8.36 | 0.28 | |||
|
| ||||||
| Vocal cord dysfunction during the hospitalization | 3.49 | 1.77, 6.90 | 0.0003 | 1.92 | 0.89, 4.15 | 0.096 |
OR = (unadjusted) odds ratio, AOR = adjusted odds ratio, Ref = reference category, STAT = Society of Thoracic Surgeons-European association for cardiothoracic surgery, CICU = cardiac ICU.
a
p value from a repeated-measures analysis using generalized estimating equations accounting for within-center correlations only.
b
p value from a repeated-measures analysis using generalized estimating equations accounting for within-center correlations, age at hospital admission, airway anomaly, STAT category, reason for the initial CICU encounter, duration of mechanical ventilation, extubation in CICU, and vocal cord dysfunction during hospitalization.