Analysis of pre-admission risk factors for unplanned reintubation in geriatric trauma patients.

INTRODUCTION

Reintubation in unplanned scenarios, carries inherent risks and potential complications particularly in vulnerable populations such as geriatric trauma patients. We sought to identify preadmission risk factors for unplanned re-intubation (URI) in geriatric trauma patients and its effects on outcomes.

METHODS

Analysis of TQIP (2017-2019) of intubated geriatric trauma patients, classified into two groups, those who were successfully extubated and those who required URI. We used logistic regression to assess for preadmission risk factors of URI.

RESULTS

Among 23,572 patients, 20.2 ​% underwent URI. URI had higher mortality (13.7%vs.8.1 ​%, p ​< ​0.001), in-hospital complications (p ​< ​0.05), longer hospital and ICU LOS (p ​< ​0.001 for both). Higher age (OR ​= ​1.017), smoking (OR ​= ​1.418), CRF(OR ​= ​1.414), COPD (OR ​= ​1.410), alcohol use (OR ​= ​1.365), functionally dependent health status (OR ​= ​1.339), and anticoagulant use (OR ​= ​1.148), increased the risks of URI (p ​< ​0.05 for all).

CONCLUSION

Geriatric patients with comorbidities including age, smoking, CRF, COPD, alcohol use, dependent status, and anticoagulant use are at higher risks of URI that could in turn, be associated with increased rates of mortality, complications, and longer hospital and ICU length of stay.

LEVEL OF EVIDENCE: Level III retrospective study.