Risk markers for postoperative reintubation of intensive care unit patients: A retrospective multicentre study of the National Intensive Care Registry.

OBJECTIVES

To evaluate postoperative reintubation incidence and identify risk markers to expedite the identification of high-risk patients after ICU admission.

METHODS

We performed this retrospective multicentre study that included postoperative adult patients admitted to Japanese ICUs between April 2015 and March 2022 using the Japanese Intensive care PAtient Database (JIPAD). Data regarding the patients treated in included ICUs were accumulated by the JIPAD, which we received for research use. Logistic regression analysis with generalised estimating equations was used to estimate odds ratios (ORs) of 1-standard deviation increments and 95 % confidence intervals (CIs) for the association of each variable available within 24 h after ICU admissions with reintubation.

RESULTS

Among 13,219 admissions during the study period, 828 patients were postoperatively reintubated (incidence = 6.26 %, 95 % CI: 5.86-6.69). Maximum partial pressure of carbon dioxide (PaCO2), bilirubin, and blood urea nitrogen (adjusted OR = 1.138, 95 % CI: 1.055-1.228; adjusted OR = 1.101, 95 % CI: 1.018-1.191; and adjusted OR = 1.105, 95 % CI: 1.016-1.203, respectively) and body mass index (BMI) and minimum white blood cells counts (adjusted OR = 0.867, 95 % CI: 0.797-0.944; and adjusted OR = 0.878, 95 % CI: 0.815-0.946, respectively) were significantly associated with postoperative reintubation.

CONCLUSIONS

Postoperative reintubation incidence in Japanese ICUs was estimated to be 6.26%. BMI, maximum PaCO2, clinical laboratory data reflecting surgical invasiveness, and immunosuppression may be risk markers for postoperative reintubation.

IMPLICATIONS FOR CLINICAL PRACTICE: Our study will help identify high-risk patients for postoperative reintubation early post-ICU admission, enabling early and focused nursing care to prevent reintubation, such as early mobilisation and ambulation.