Risk factors of self-extubation in intensive care. Retrospective cohort study

Carlos Eduardo Laverde-Sabogal, Carmelo José Espinosa-Almanza, Daniela Patiño-Hernández, Horacio Rodríguez-Escallón, Juan Camilo Aguado-Valderrama, Paula Lara-Monsalve

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Introduction Acute respiratory failure remains one of the three leading causes of admission to the intensive care unit (ICU). Self-extubation is an adverse outcome requiring reintubation in 50% of cases. Objective To assess for determinants (risk factors) of self-extubation and mortality in the ICU by using a generalized estimation equation model (GEE). Methods The data was collected from a retrospective cohort study from 2017-2020 including all patients admitted to the ICU with mechanical ventilation. Univariate and bivariate analyses were performed. Then, a GEE model was conducted to predict the risk of self-extubation and mortality. Results A total of 857 subjects were included, with a mean age of 60.5 +/- 17 years-old. Most of the subjects were males (55.2%). An 8.99-fold risk (95%CI 3.83-21.1, p<0.01) of self-extubation was identified in patients with agitation. Exposure to infusion of neuromuscular blockade was also found to increase the risk of self-extubation 3.37 times (95%CI 1.31-8.68, p=0.01). No associations were identified between immobilization and self-extubation (OR 1.38 95%CI 0.76-2.51, p=0.29). Finally, light sedation according to the Richmond Sedation Scale (RASS) between 0 to -2 rather than moderate (RASS-3) reduces the risk of mortality (OR 0.57, 95%CI 0.38-0.83, p<0.01). Conclusions The main factors resulting in self-extubation were: agitation, delirium, and infusion of neuromuscular blocking agents. An association was found between light sedation and a lower risk of mortality. No association was found between the use of physical restraint and the desired outcome.

Translated title of the contributionFactores de riesgo de autoextubación en cuidado intensivo. Estudio de cohorte retrospectiva
Original languageEnglish
Article numbere1050
JournalColombian Journal of Anesthesiology
Issue number2
StatePublished - 2023
Externally publishedYes


  • Airway extubation
  • Anesthesiology
  • Artificial respiration
  • Critical care
  • Self-Extubation


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