Chu et al identified risk factors for reintubation within 14 days after a patient has been removed from mechanical ventilation. These can help to identify a patient who may require more aggressive management to avoid relapse. The authors are from China Medical University, Nantou Hospital, Chung-Yuan Christian University and Asia University in Taiwan.
Patient selection: age >= 17 years old on mechanical ventilator. Most patients were 65-84 years of age.
Outcome: reintubation within 14 days (rate in study population 2.8%)
Risk factors for reintubation:
(1) reason for initial intubation (COPD)
(2) accreditation level of hospital where treated (district vs regional or academic/referral)
(3) location (respiratory care ward or home respiratory care, vs ICU or respiratory care center)
• The location of care may reflect chronic, late stage pulmonary disease.
A patient who is reintubated tends to have a poor prognosis. Taking steps to avoid preventable reintubation may improve outcomes. A patient who requires reintubation should be treated in the ICU because of greater risk.
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