scholarly journals Extubation Failure in a Burn Intensive Care Unit: Examination of Contributing Factors

2020 ◽  
Author(s):  
Julie A Rizzo ◽  
Mahdi Haq ◽  
Ryan A McMahon ◽  
James K Aden ◽  
Daniel B Brillhart ◽  
...  
Keyword(s):  
Extubation Failure ◽  
Case Control ◽  
Inhalation Injury ◽  
Control Analysis ◽  
Burn Patients ◽  
Contributing Factors ◽  
Matched Case ◽  
Case Control Analysis ◽  
Patients Experience ◽  
The Impact

Abstract Extubation failure is associated with negative outcomes making the identification of risk factors for failure paramount. Burn patients experience a high incidence of respiratory failure requiring mechanical ventilation. There is no consensus on the acceptable rate of extubation failure and many conventional indices do not accurately predict extubation outcomes in burn patients. The purpose of this study was to examine the rate of extubation failure in the burned population and to examine the impact of factors on extubation outcomes. Burn patients from a single center over 9 years were examined and included if they were intubated prior to arrival or within 48 hours of admission and underwent a planned extubation. From this cohort, a matched case–control analysis based on age, TBSA, and sex was performed of patients who succeeded after extubation, defined as not requiring reintubation within 72 hours, to those who failed. Characteristics and clinical parameters were compared to determine whether any factors could predict extubation failure. There was a 12.3% incidence of extubation failure. In the matched case–control analysis, the presence of inhalation injury was associated with extubation success. Higher heart rate and lower serum pH were associated with extubation failure. ANCOVA analysis demonstrated that a sodium trending higher before extubation was associated with more successes, possibly indicative of a lower volume status. Classic extubation criteria do not accurately predict extubation outcomes in burn patients; analysis of other parameters may be able to provide better predictions. A constellation of these parameters needs to be studied prospectively.

510 Incidence of Extubation Failure in a Burn Intensive Care Unit: Examination of Contributing` Factors

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S91-S92
Author(s):  
Julie A Rizzo ◽  
Ryan McMahon ◽  
James K Aden ◽  
Daniel B Brillhart ◽  
Leopoldo C Cancio
Keyword(s):  
Extubation Failure ◽  
Case Control ◽  
Inhalation Injury ◽  
Control Analysis ◽  
Clinical Parameters ◽  
Burn Patients ◽  
Extubation Outcome ◽  
Matched Case ◽  
Case Control Analysis ◽  
The Impact

Abstract Introduction Extubation failure is associated with negative outcomes making the identification of risk factors for failure paramount to patient selection. Burn patients experience a high incidence of respiratory failure requiring mechanical ventilation. There is no consensus on the acceptable rate of extubation failure and many conventional indices used in critical care do not accurately predict extubation outcome in burn patients. The purpose of this study was to examine the rate of extubation failure in the burned population and to examine the impact of inhalation injury, as well as other factors, on extubation outcome. Methods Burn patients from a single center over the period 2009–2017 were examined and included if they were intubated prior to arrival or within 48 hours of admission and underwent a planned extubation. Patients were excluded if they proceeded directly to tracheostomy, died prior to extubation, or experienced an unintentional extubation. From this cohort, a matched case-control analysis based on age, TBSA and gender was performed of patients who succeeded after extubation, defined as not requiring reintubation within 72 hours of extubation, to those who failed. Characteristics and clinical parameters were compared between these two groups to determine if any factor(s) could predict extubation failure. Results A 12.3% incidence of extubation failure was found in our cohort of 106 burn patients. In the matched case-control analysis of 48 extubation successes and 58 extubation failures, the presence of inhalation injury was surprisingly associated with extubation success as was a higher PaO2:FiO2 ratio immediately prior to extubation. Higher heart rate and lower serum pH was associated with extubation failure. ANCOVA analysis demonstrated that a sodium trending higher before extubation was associated with more successes, possibly indicative of a lower volume status. Conclusions Classic extubation criteria do not accurately predict extubation outcome in burn patients; analysis of other characteristics and clinical parameters may be able to provide better predictions. A constellation of these parameters needs to be studied prospectively. Applicability of Research to Practice Defining a constellation of parameters that can aid in identifying those at high risk of extubation failure could change practice.

Influence of Prognostic Risk Indicators on Osseointegrated Dental Implant Failure: A Matched Case-Control Analysis

2012 ◽  
Vol 38 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Rami Alissa ◽  
Richard J. Oliver
Keyword(s):  
Dental Implant ◽  
Case Control ◽  
Implant Failure ◽  
Risk Indicators ◽  
Therapeutic Modality ◽  
Control Analysis ◽  
Wide Diameter ◽  
Related Risk ◽  
Matched Case ◽  
Case Control Analysis

Dental implant treatment is an important therapeutic modality with documented long-term success for replacement of missing teeth. However, dental implants can be susceptible to disease conditions or healing complications that may lead to implant loss. This case-control study identified several risk indicators associated with failure such as smoking and alcohol consumption. The use of postoperative antibiotics or wide-diameter implants may significantly reduce implant failure. Knowledge of patient-related risk factors may assist the clinician in proper case selection and treatment planning.

scholarly journals Life-threatening alcohol-related traffic crashes in adverse weather: a double-matched case–control analysis from Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024415 ◽  
Author(s):  
Donald A Redelmeier ◽  
Fizza Manzoor
Keyword(s):  
Relative Risk ◽  
Case Control ◽  
Additional Patient ◽  
Control Analysis ◽  
Drinking And Driving ◽  
Traffic Crash ◽  
Adverse Weather ◽  
Life Threatening ◽  
Matched Case ◽  
Case Control Analysis

ImportanceDrunk driving is a major cause of death in North America, yet physicians rarely counsel patients on the risks of drinking and driving.ObjectiveTo test whether the risks of a life-threatening alcohol-related traffic crash were further accentuated by adverse weather.DesignDouble matched case–control analysis of hospitalised patients.SettingCanada’s largest trauma centre between 1 January 1995 and 1 January 2015.ParticipantsPatients hospitalised due to a life-threatening alcohol-related traffic crash.ExposureRelative risk of a crash associated with adverse weather estimated by evaluating the weather at the place and time of the crash (cases) compared with the weather at the same place and time a week earlier and a week later (controls).ResultsA total of 2088 patients were included, of whom the majority were drivers injured at night. Adverse weather prevailed among 312 alcohol-related crashes and was significantly more frequent compared with control circumstances. The relative risk of a life-threatening alcohol-related traffic crash was 19% higher during adverse weather compared with normal weather (95% CI: 5 to 35, p=0.006). The absolute increase in risk amounted to 43 additional crashes, extended to diverse groups of patients, applied during night-time and daytime, contributed to about 793 additional patient-days in hospital and was distinct from the risks for drivers who were negative for alcohol.ConclusionsAdverse weather was associated with an increased risk of a life-threatening alcohol-related traffic crash. An awareness of this risk might inform warnings to patients about traffic safety and counselling alternatives to drinking and driving.

Morbidity of Staged Proctectomy After Hepatectomy for Colorectal Cancer: A Matched Case–Control Analysis

2012 ◽  
Vol 20 (2) ◽  
pp. 482-490 ◽  
Author(s):  
Ching-Wei D. Tzeng ◽  
Thomas A. Aloia ◽  
Jean-Nicolas Vauthey ◽  
George J. Chang ◽  
Lee M. Ellis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Case Control ◽  
Control Analysis ◽  
Matched Case ◽  
Case Control Analysis
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