Risk factors and prognosis analysis of reintubation in critically mechanical ventilation patients with cancer

Abstract

Objective To determine the risk factors and prognosis of reintubation in critically mechanical ventilation patients with cancer. Methods Patients who received mechanical ventilation longer than 48 h in Intensive Care Unit (ICU) from June 2013 to January 2015 were enrolled in analyses. Patients were divided into 2 groups: reintubation group (n=16) and non-reintubation group (n=64) according to whether patients were reintubated after planned extubation. Basic clinical data of patients were retrospectively collected and reviewed. Univariate and multivariable logistic regression analysis were used to determine the risk factors of reintubation. Results (1)Among all of the 80 patients, 16 (20%) patients were re-intubated after extubation. There were no significant differences between two groups in the age, gender, body mass index (BMI) and constituent ratio of primary tumor sites etc (P>0.05). (2) Univariate analysis showed that compared with patients in non-reintubation group, patients in reintubation group were associated with higher age-adjusted Charlson score (3.7±1.4 vs 2.9±1.4, t=2.300, P=0.024), more spontaneous breathing trials, (2.9±2.4 vs. 1.7±1.6, t=2.409, P=0.018). (3) Multi-variable analysis demonstrated that age-adjusted Charlson score was the only risk factor of reintubation in critically ill patients with cancer (OR=1.583, 95%CI: 1.084~2.312; P=0.017). (4) Compared with patients in non-reintubation group, patients in reintubation group were associated with longer duration of ventilation (19.9±20.1 vs 7.0±6.1, t=27.752, P 0.05). Conclusions Age-adjusted Charlson score is the risk factor of reintubation in critically ill patients with cancer. Reintubation is associated with longer ICU length of stay and longer duration of mechanical ventilation. Key words: Tracheal intubation; Risk factor; Charlson score; Intensive care unit