Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13274
Peer-review started: September 7, 2022
First decision: November 11, 2022
Revised: December 5, 2022
Article in press: December 5, 2022
Published online: December 26, 2022
Processing time: 103 Days and 13.7 Hours
Critical patients often had various types of tubes, unplanned extubation of any kind of tube may cause serious injury to the patient, but previous reports mainly focused on endotracheal intubation. The limitations or incorrect use of the unplanned extubation risk assessment tool may lead to improper identification of patients at a high risk of unplanned extubation and cause delay or non-implementation of unplanned extubation prevention interventions.
Previous studies about unplanned extubation risk assessment lacked the support of clinical data. The reliability and validity of the previous risk assessment scales and their practicability and popularization cannot be confirmed. To effectively identify and manage the risk of unplanned extubation, a comprehensive, universal, and effective unplanned extubation risk assessment tool is needed.
To assess the predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale in inpatients.
We performed a retrospective validation study. For patients with tubes during hospitalization, the patient characteristic, whether unplanned extubation occurred and the Huaxi Unplanned Extubation Risk Assessment Scale (HUERAS) score were extracted. The best cut-off value and the area under the curve (AUC) of the Huaxi Unplanned Extubation Risk Assessment Scale were been identified.
A total of 76033 inpatients with indwelling tubes were included in this study, and 26 unplanned extubations occurred. The best cut-off value was 21, and the Cronbach’s α, sensitivity, specificity, positive predictive value, and negative predictive value of the HUERAS were 0.815, 84.62%, 81.43%, 0.16%, and 99.99%, respectively. The AUC of HUERAS was 0.851 (95%CI: 0.783-0.919, P < 0.001). The prediction validity and generalization of the HUERAS need to be further confirmed by multi center research.
The HUERAS has good reliability and predictive validity. It can effectively identify inpatients at a high risk of unplanned extubation and help clinical nurses carry out risk screening and management.
Larger studies with multiple centers are needed to further confirm the prediction validity and generalization of the HUERAS.