Self-extubation in critically ill patients: from the French OUTCOMEREA Network
Authors' conclusion
Enteral nutrition on the day of SE, prolonged mechanical ventilation prior to SE, higher non-neurological SOFA scores, and use of NIV after SE were independently associated with the need for reintubation. Reintubation was also associated with increased mortality, a higher risk of nosocomial pneumonia, and prolonged ICU stay.
Study context
- Population
- Intubated intensive care unit (ICU) patients with self-extubation (SE) without therapeutic limitations, French OutcomeRea™ database, November 1996–May 202212,917 intubated
- Participants
- 701 patients
- Exposure
- Reintubation vs no reintubation within 48 h after self-extubation
- Reintubationn = 276
- Outcome
- Factors associated with reintubation after SE
- Follow-up
- 48 h
Methodological detailsmulticentre ICU database (OutcomeRea™), adjusted analyses
- Multicentre ICU database (OutcomeRea™)
- Adjusted analyses
Main finding
As reported in the abstract
Factors associated with reintubation within 48 h after SE
Reintubation
39.4%
276
- Higher non-neurological SOFA score on the day before SE (adjusted OR, p = 0.03)
- 1.16 [1.01; 1.34]
- Invasive mechanical ventilation > 7 days before SE (adjusted OR, p = 0.04)
- 1.79 [1.04; 3.26]
- Enteral nutrition on the day of SE (adjusted OR, p < 0.01)
- 2.59 [1.75; 3.84]
- Non-invasive ventilation (NIV) within 24 h after SE (adjusted OR, p < 0.01)
- 0.28 [0.16; 0.5]
Observational data: associations, not effects.
Secondary outcomes
28-day mortality, reintubation vs none
| HR (CI) | P value | ||
|---|---|---|---|
| ReintubatedIndependently associated | 3.03 (1.79–5.12) | P < 0.01 | |
| 0.20.5125Hazard ratio (log scale) |
90-day mortality, reintubation vs none
| HR (CI) | P value | ||
|---|---|---|---|
| ReintubatedIndependently associated | 2.86 (1.86–4.4) | P < 0.01 | |
| 0.20.5125Hazard ratio (log scale) |
Nosocomial pneumonia, reintubation vs none
| sdHR (CI) | P value | ||
|---|---|---|---|
| Reintubated | 18.28 (7.70–43.42) | P < 0.01 | |
| 0.050.21520Subdistribution hazard ratio (log scale) |
| Outcome | Increase (days) | P value |
|---|---|---|
| ICU LOS, reintubation vs none | 13 | P < 0.01 |
Original publication
Self-extubation in critically ill patients: from the French OUTCOMEREA Network. Crit Care. Published 7 July 2025. doi:10.
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