Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury

Detalhes bibliográficos
Autor(a) principal: Reis,Helena Franca Correia dos
Data de Publicação: 2013
Outros Autores: Almeida,Monica Lajana Oliveira, Silva,Mario Ferreira da, Rocha,Mario de Seixas
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Pneumologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132013000300330
Resumo: OBJECTIVE: To evaluate the association between extubation failure and outcomes (clinical and functional) in patients with traumatic brain injury (TBI). METHODS: A prospective cohort study involving 311 consecutive patients with TBI. The patients were divided into two groups according to extubation outcome: extubation success; and extubation failure (defined as reintubation within 48 h after extubation). A multivariate model was developed in order to determine whether extubation failure was an independent predictor of in-hospital mortality. RESULTS: The mean age was 35.7 ± 13.8 years. Males accounted for 92.3%. The incidence of extubation failure was 13.8%. In-hospital mortality was 4.5% and 20.9% in successfully extubated patients and in those with extubation failure, respectively (p = 0.001). Tracheostomy was more common in the extubation failure group (55.8% vs. 1.9%; p < 0.001). The median length of hospital stay was significantly greater in the extubation failure group than in the extubation success group (44 days vs. 27 days; p = 0.002). Functional status at discharge was worse among the patients in the extubation failure group. The multivariate analysis showed that extubation failure was an independent predictor of in-hospital mortality (OR = 4.96; 95% CI, 1.86-13.22). CONCLUSIONS: In patients with TBI, extubation failure appears to lengthen hospital stays; to increase the frequency of tracheostomy and of pulmonary complications; to worsen functional outcomes; and to increase mortality.
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spelling Extubation failure influences clinical and functional outcomes in patients with traumatic brain injuryBrain injuriesVentilator weaningIntensive care unitsGlasgow outcome scale OBJECTIVE: To evaluate the association between extubation failure and outcomes (clinical and functional) in patients with traumatic brain injury (TBI). METHODS: A prospective cohort study involving 311 consecutive patients with TBI. The patients were divided into two groups according to extubation outcome: extubation success; and extubation failure (defined as reintubation within 48 h after extubation). A multivariate model was developed in order to determine whether extubation failure was an independent predictor of in-hospital mortality. RESULTS: The mean age was 35.7 ± 13.8 years. Males accounted for 92.3%. The incidence of extubation failure was 13.8%. In-hospital mortality was 4.5% and 20.9% in successfully extubated patients and in those with extubation failure, respectively (p = 0.001). Tracheostomy was more common in the extubation failure group (55.8% vs. 1.9%; p < 0.001). The median length of hospital stay was significantly greater in the extubation failure group than in the extubation success group (44 days vs. 27 days; p = 0.002). Functional status at discharge was worse among the patients in the extubation failure group. The multivariate analysis showed that extubation failure was an independent predictor of in-hospital mortality (OR = 4.96; 95% CI, 1.86-13.22). CONCLUSIONS: In patients with TBI, extubation failure appears to lengthen hospital stays; to increase the frequency of tracheostomy and of pulmonary complications; to worsen functional outcomes; and to increase mortality. Sociedade Brasileira de Pneumologia e Tisiologia2013-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132013000300330Jornal Brasileiro de Pneumologia v.39 n.3 2013reponame:Jornal Brasileiro de Pneumologia (Online)instname:Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)instacron:SBPT10.1590/S1806-37132013000300010info:eu-repo/semantics/openAccessReis,Helena Franca Correia dosAlmeida,Monica Lajana OliveiraSilva,Mario Ferreira daRocha,Mario de Seixaseng2013-10-08T00:00:00Zoai:scielo:S1806-37132013000300330Revistahttp://www.jornaldepneumologia.com.br/default.aspONGhttps://old.scielo.br/oai/scielo-oai.php||jbp@jbp.org.br|| jpneumo@jornaldepneumologia.com.br1806-37561806-3713opendoar:2013-10-08T00:00Jornal Brasileiro de Pneumologia (Online) - Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)false
dc.title.none.fl_str_mv Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury
title Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury
spellingShingle Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury
Reis,Helena Franca Correia dos
Brain injuries
Ventilator weaning
Intensive care units
Glasgow outcome scale
title_short Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury
title_full Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury
title_fullStr Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury
title_full_unstemmed Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury
title_sort Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury
author Reis,Helena Franca Correia dos
author_facet Reis,Helena Franca Correia dos
Almeida,Monica Lajana Oliveira
Silva,Mario Ferreira da
Rocha,Mario de Seixas
author_role author
author2 Almeida,Monica Lajana Oliveira
Silva,Mario Ferreira da
Rocha,Mario de Seixas
author2_role author
author
author
dc.contributor.author.fl_str_mv Reis,Helena Franca Correia dos
Almeida,Monica Lajana Oliveira
Silva,Mario Ferreira da
Rocha,Mario de Seixas
dc.subject.por.fl_str_mv Brain injuries
Ventilator weaning
Intensive care units
Glasgow outcome scale
topic Brain injuries
Ventilator weaning
Intensive care units
Glasgow outcome scale
description OBJECTIVE: To evaluate the association between extubation failure and outcomes (clinical and functional) in patients with traumatic brain injury (TBI). METHODS: A prospective cohort study involving 311 consecutive patients with TBI. The patients were divided into two groups according to extubation outcome: extubation success; and extubation failure (defined as reintubation within 48 h after extubation). A multivariate model was developed in order to determine whether extubation failure was an independent predictor of in-hospital mortality. RESULTS: The mean age was 35.7 ± 13.8 years. Males accounted for 92.3%. The incidence of extubation failure was 13.8%. In-hospital mortality was 4.5% and 20.9% in successfully extubated patients and in those with extubation failure, respectively (p = 0.001). Tracheostomy was more common in the extubation failure group (55.8% vs. 1.9%; p < 0.001). The median length of hospital stay was significantly greater in the extubation failure group than in the extubation success group (44 days vs. 27 days; p = 0.002). Functional status at discharge was worse among the patients in the extubation failure group. The multivariate analysis showed that extubation failure was an independent predictor of in-hospital mortality (OR = 4.96; 95% CI, 1.86-13.22). CONCLUSIONS: In patients with TBI, extubation failure appears to lengthen hospital stays; to increase the frequency of tracheostomy and of pulmonary complications; to worsen functional outcomes; and to increase mortality.
publishDate 2013
dc.date.none.fl_str_mv 2013-06-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132013000300330
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1806-37132013000300010
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Pneumologia e Tisiologia
publisher.none.fl_str_mv Sociedade Brasileira de Pneumologia e Tisiologia
dc.source.none.fl_str_mv Jornal Brasileiro de Pneumologia v.39 n.3 2013
reponame:Jornal Brasileiro de Pneumologia (Online)
instname:Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)
instacron:SBPT
instname_str Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)
instacron_str SBPT
institution SBPT
reponame_str Jornal Brasileiro de Pneumologia (Online)
collection Jornal Brasileiro de Pneumologia (Online)
repository.name.fl_str_mv Jornal Brasileiro de Pneumologia (Online) - Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)
repository.mail.fl_str_mv ||jbp@jbp.org.br|| jpneumo@jornaldepneumologia.com.br
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