Variation in tracheal reintubations among patients undergoing cardiac surgery across washington state hospitals

Nita Khandelwal, Christopher R. Dale, David C. Benkeser, Aaron M. Joffe, Norbert David Yanez, Miriam M. Treggiari

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Objectives 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. Design Retrospective cohort study. Setting All nonfederal hospitals performing cardiac surgery in Washington state. Participants A total of 15,103 patients undergoing coronary artery bypass grafting or valvular surgery between January 1, 2008 and September 30, 2011. Interventions None. Measurements and Main Results 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). Conclusions 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.

Original languageEnglish (US)
Pages (from-to)551-559
Number of pages9
JournalJournal of cardiothoracic and vascular anesthesia
Volume29
Issue number3
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

Keywords

  • cardiac surgery
  • critical care
  • extubation failure
  • outcomes
  • reintubation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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