Assessment of the incidence and associated factor of failed extubation at adult intensive care units at Tikur Anbessa Specialized Hospital and Menelik II Compressive Specialized Hospital in Addis Ababa, Ethiopia.
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Date
2024
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Addis Ababa University
Abstract
Background: Extubation Failure (EF) is one of the common events in the intensive care unit
(ICU). The incidence of EF can be as high as 17%. While most articles define EF as re-
intubation within 72 hours after planned extubation, some studies narrowed it down to 24 hours.
Objective: Assessment of the incidence and associated factor of failed extubation at adult ICUs
at Tikur Anbessa specialized hospital and Menelik II comprehensive specialized hospital in
Addis Ababa, Ethiopia.
Methods: From October to March 2024, a hospital-based cross-sectional study was conducted in
the intensive care unit, which fulfilled the inclusion criteria at Tikur Anbessa specialized hospital
and Menelik II comprehensive specialized hospital in Addis Ababa, Ethiopia.. The data
collection method included questionnaires and patient chart reviews , which were fulfilled by
the ICU physicians. Then the date collected was entered into Epi-data software (version 4.6.0.2)
and was analyzed using the Statistical Package for the Social Sciences (SPSS version 25)
statistical software. Independent and dependent variable were analyzed using binary logistic
regression to determine if the variables were independently predictive of failed extubation. Odd
ratio, P-value, and 95% confidence interval were calculated to differentiate risk factors and to
assess association strength. Variables with a P-value of 0.25 on bivariate analysis were evaluated
using multivariable analysis, and a P-value less than 0.05 was used as the cut point to test the
statistical significance.
Result: In this study, the prevalence of extubation failure was significantly palpable (21%). The
determinant factors for extubation failure were:
Age (greater than 60 years of age) compared to those of 15-30 years olds (AOR=2.7,
95%CI=1.26, 28.74)
Length of stay on mechanical ventilation (greater than 10 days) compared to those of
LOS mechanical ventilation less or equal to 4 days (AOR=14.9, 95%CI=4.17, 54.80),
Systolic blood pressure of (greater or equal to 140) compared to those SBP of 90-129
(AOR=18.5, 95%CI=1.91, 78.63)
GCS of 5-7T compared to those of GCS 8-10T (AOR=16.7, 95%CI=2.09, 34.12), and
Residency of internal medicine compared to those of residency ACCPM (AOR=2.7,
95%CI=1.30, 23.69).
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Keywords
Failed extubation, associated factor, LOS