Incidence of extubation failure and its predictors among adult mechanically ventilated patients in selected public hospitals intensive care unit, Addis Ababa city administration, Ethiopia.

Abstract

Abstract Background: Extubation failure is a common complication in critically ill adult patients who require mechanical ventilation. It occurs when a patient cannot be successfully weaned from the ventilator and requires reintubation. This can lead to significant morbidity and mortality, as well as increased healthcare costs. Identifying and addressing risk factors can help improve outcomes for critically ill adult patients. Despite, the rising number of patients on mechanically ventilated in Ethiopia, there is limited data on the incidence of extubation failure and its predictors in mechanically ventilated patients. Objective: To assess Incidence of extubation failure and its predictors among adults mechanically ventilated patients at selected public hospitals ICU in Addis Ababa, Ethiopia, 2023. Methods: An institution based cohort study was conducted. A total of 202 adults mechanically ventilated patients were selected using a simple sampling technique. All adult mechanically ventilated patients at the selected public hospital from September 1, 2022, to August 31, 2023, were included whereas patients who had incomplete charts which missed the outcome variable were excluded. The data were collected by reviewing their medical records from September 1, 2022, to August 31, 2023.Variables having a p-value < 0.05 in the multivariate analysis was considered as statistically significant. The strength of association will be summarized by using an adjusted Odds ratio with corresponding 95% confidence interval. Results: Out of the 202 ICU patients, 45.54% [95%CI 0.387- 0.52] developed Extubation Failure. Medical complication on MV Like AKI,AOR:0.05[95%CI:0.003-0.60] prolonged duration on MV > 10 days AOR: 5.3[95%CI:1.01-27.7],GCS<10,AOR:5.9[95%CI:1.39-25.15],Increased endotracheal secretion: AOR: 19.07[95%CI:0.9-28.29]and greater than 2 times SBTs, AOR: 9.37[95%CI: 1.38-63.48] were significantly associated with the extubation failure. Conclusion The incidence of extubation failure was one out of five in our study area. Medical complication on MV, Duration on MV ≥ 10 days, GCS < 10, Copious tracheal secretions and Frequency of SBTs > 2 times are independent variables those significantly predict the extubation failure. Keywords: Extubation Failure, Extubation and Ethiopia.