Analysis and prediction model of factors related to unplanned extubation after arterial catheterization in ICU patients with severe disease
Objective To analyze the factors associated with unplanned extubation(UEX)after arterial catheterization in critically ill patients in the intensive care unit(ICU)and to construct and validate a predictive model.Methods A retrospective analysis was conducted on 104 critically ill patients admitted to the ICU of Huai'an First Hospital Affiliated to Nanjing Medical University from January 2020 to December 2022.Patients were divided into a routine extubation group(n=80)and a UEX group(n=24)based on the occurrence of UEX after arterial catheterization.Univariate analysis was performed to identify potential risk factors for UEX,followed by binary logistic regression analysis to select independent risk factors.A predictive model was constructed using these independent risk factors,and its predictive accuracy was verified using the receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results Of the 104 critically ill patients,24(23.08%)experienced UEX after arterial catheterization.Univariate analysis indicated that age(t=3.585,P<0.001),hypertension(χ2=9.069,P=0.003),venous thrombosis(χ2=12.076,P<0.001),sedative use(χ2=4.287,P=0.038),and catheterization duration(t=3.127,P=0.002)were significantly associated with UEX.Multivariate analysis revealed that advanced age(OR=1.038,95%CI=1.009～1.068,P=0.009),venous thrombosis(OR=5.133,95%CI=1.404～18.767,P=0.013),and prolonged catheterization(OR=1.587,95%CI=1.122～2.244,P=0.009)are independent risk factors for UEX in critically ill ICU patients.The predictive model constructed with these factors showed an AUC of 0.776 upon ROC validation,indicating moderate to good predictive accuracy for UEX risk following arterial catheterization in the ICU.Conclusion Advanced age,venous thrombosis,and prolonged catheterization duration are independent risk factors for UEX after arterial catheterization in critically ill ICU patients.
ICU critical illnessArterial catheterizationUnplanned extubationRisk factor analysisPrediction model
万方数据
维普
