Neuroanesthesia & neurocritical care
Development of a Prediction Score for Evaluation of Extubation Readiness in Neurosurgical Patients with Mechanical Ventilation
Authors' conclusion
After a survey of the reasons for delayed extubation, the STAGE scoring system was developed to better predict the extubation success rate.
Study context
- Population
- Mechanically ventilated neurosurgical patients with extubation attempts, already meeting other general extubation criteria3,171 screened
- Participants
- 226 participants
- Outcome
- Extubation success
Methodological detailssingle-centre, prospective observational, consecutive enrolment, Physicians surveyed on reasons for delayed extubation
- Single-centre
- Prospective observational
- Consecutive enrolment
- Physicians surveyed on reasons for delayed extubation
Performance
As reported in the abstract
Prediction of extubation success
| Test or model | AUC (total score) | Sensitivity (cutoff 6) | Specificity (cutoff 6) | PPV (cutoff 6) | NPV (cutoff 6) | Specificity (score ≥9) | PPV (score ≥9) |
|---|---|---|---|---|---|---|---|
| STAGE score | 0.72 (95% CI, 0.64 to 0.79) | 59% (95% CI, 51 to 66%) | 74% (95% CI, 59 to 86%) | 90% (95% CI, 84 to 95%) | 30% (95% CI, 21 to 39%) | 100% (95% CI, 90 to 100%) | 100% (95% CI, 72 to 100%) |
STAGE score
AUC (total score)0.72 (95% CI, 0.64 to 0.79)
Sensitivity (cutoff 6)59% (95% CI, 51 to 66%)
Specificity (cutoff 6)74% (95% CI, 59 to 86%)
PPV (cutoff 6)90% (95% CI, 84 to 95%)
NPV (cutoff 6)30% (95% CI, 21 to 39%)
Specificity (score ≥9)100% (95% CI, 90 to 100%)
PPV (score ≥9)100% (95% CI, 72 to 100%)
Further findings
- Delayed extubation
- 25% (57 of 226)
- Extubation failure
- 19% (43 of 226)
- Most common reasons for delay: weak airway-protecting function and poor consciousness
Original publication
Development of a Prediction Score for Evaluation of Extubation Readiness in Neurosurgical Patients with Mechanical Ventilation. Anesthesiology. Published 3 August 2023. doi:10.
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