Variation in Tracheal Reintubations Among Patients Undergoing Cardiac Surgery Across Washington State Hospitals

The objectives of this study were to examine the variation in reintubations across Washington state hospitals that perform cardiac surgery, and explore hospital and patient characteristics associated with variation in reintubation. Retrospective cohort study. All nonfederal hospitals performing card...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia Vol. 29; no. 3; pp. 551 - 559
Main Authors: Khandelwal, Nita, Dale, Christopher R., Benkeser, David C., Joffe, Aaron M., David Yanez, Norbert, Treggiari, Miriam M.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.06.2015
Subjects:
Adult
Aged
Airway Extubation
Airway Management - adverse effects
Airway Management - statistics & numerical data
Anesthesia & Perioperative Care
cardiac surgery
Cardiac Surgical Procedures - methods
Cohort Studies
Coronary Artery Bypass
Critical Care
Critical Care - statistics & numerical data
Databases, Factual
extubation failure
Female
Health Surveys
Humans
Intubation, Intratracheal - adverse effects
Intubation, Intratracheal - statistics & numerical data
Male
Middle Aged
outcomes
reintubation
Retrospective Studies
Risk Factors
Socioeconomic Factors
Treatment Failure
Treatment Outcome
Washington
Washington
critical care
extubation failure
cardiac surgery
reintubation
outcomes
ISSN:1053-0770, 1532-8422, 1532-8422
Online Access:Get full text
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Summary:The objectives of this study were to examine the variation in reintubations across Washington state hospitals that perform cardiac surgery, and explore hospital and patient characteristics associated with variation in reintubation. Retrospective cohort study. All nonfederal hospitals performing cardiac surgery in Washington state. A total of 15,103 patients undergoing coronary artery bypass grafting or valvular surgery between January 1, 2008 and September 30, 2011. None. Patient and hospital characteristics were compared between hospitals that had a reintubation frequency≥5% or<5%. Multivariate logistic regression was used to compare the odds of reintubation across the hospitals. The authors tested for heterogeneity of odds of reintubation across hospitals by performing a likelihood ratio test on the hospital factor. After adjusting for patient-level characteristics and procedure type, significant heterogeneity in reintubations across hospitals was present (p = 0.005). This exploratory analyses suggested that hospitals with lower reintubations were more likely to have more acute care days and teaching intensive care units (ICU). After accounting for patient and procedure characteristics, significant heterogeneity in the relative odds of requiring reintubation was present across 16 nonfederal hospitals performing cardiac surgery in Washington state. The findings suggested that greater hospital volume and ICU teaching status were associated with fewer reintubations.
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ISSN:1053-0770
1532-8422
1532-8422
DOI:10.1053/j.jvca.2014.11.009