Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit
Introduction/objectiveExtubation failure in pediatric patients with congenital or acquired heart diseases increases morbidity and mortality. This study aimed to develop a clinical risk score for predicting extubation failure to guide proper clinical decision-making and management.MethodsWe conducted...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2024.1346198/full |
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| author | Kwannapas Saengsin Kwannapas Saengsin Rekwan Sittiwangkul Thirasak Borisuthipandit Pakpoom Wongyikul Krittai Tanasombatkul Krittai Tanasombatkul Thanaporn Phanacharoensawad Guanoon Moonsawat Konlawij Trongtrakul Konlawij Trongtrakul Phichayut Phinyo Phichayut Phinyo |
| author_facet | Kwannapas Saengsin Kwannapas Saengsin Rekwan Sittiwangkul Thirasak Borisuthipandit Pakpoom Wongyikul Krittai Tanasombatkul Krittai Tanasombatkul Thanaporn Phanacharoensawad Guanoon Moonsawat Konlawij Trongtrakul Konlawij Trongtrakul Phichayut Phinyo Phichayut Phinyo |
| author_sort | Kwannapas Saengsin |
| collection | DOAJ |
| description | Introduction/objectiveExtubation failure in pediatric patients with congenital or acquired heart diseases increases morbidity and mortality. This study aimed to develop a clinical risk score for predicting extubation failure to guide proper clinical decision-making and management.MethodsWe conducted a retrospective study. This clinical prediction score was developed using data from the Pediatric Cardiac Intensive Care Unit (PCICU) of the Faculty of Medicine, Chiang Mai University, Thailand, from July 2016 to May 2022. Extubation failure was defined as the requirement for re-intubation within 48 h after extubation. Multivariable logistic regression was used for modeling. The score was evaluated in terms of discrimination and calibration.ResultsA total of 352 extubation events from 270 patients were documented. Among these, 40 events (11.36%) were extubation failure. Factors associated with extubation failure included history of pneumonia (OR: 4.14, 95% CI: 1.83–9.37, p = 0.001), history of re-intubation (OR: 5.99, 95% CI: 2.12–16.98, p = 0.001), and high saturation in physiologic cyanosis (OR: 5.94, 95% CI: 1.87–18.84, p = 0.003). These three factors were utilized to develop the risk score. The score showed acceptable discrimination with an area under the curve (AUC) of 0.77 (95% CI: 0.69–0.86), and good calibration.ConclusionThe derived Pediatric CMU Extubation Failure Prediction Score (Ped-CMU ExFPS) could satisfactorily predict extubation failure in pediatric cardiac patients. Employing this score could promote proper personalized care. We suggest conducting further external validation studies before considering implementation in practice. |
| first_indexed | 2024-03-07T15:44:49Z |
| format | Article |
| id | doaj.art-b9a22e9c2ba54d0ea6e8b6a43467863e |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-07T15:44:49Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-b9a22e9c2ba54d0ea6e8b6a43467863e2024-03-05T05:03:08ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602024-03-011210.3389/fped.2024.13461981346198Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unitKwannapas Saengsin0Kwannapas Saengsin1Rekwan Sittiwangkul2Thirasak Borisuthipandit3Pakpoom Wongyikul4Krittai Tanasombatkul5Krittai Tanasombatkul6Thanaporn Phanacharoensawad7Guanoon Moonsawat8Konlawij Trongtrakul9Konlawij Trongtrakul10Phichayut Phinyo11Phichayut Phinyo12Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDivision of Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDivision of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandFaculty of Medicine, Chiang Mai University, Chiang Mai, ThailandFaculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDivision of Pulmonary, Critical Care Medicine, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandIntroduction/objectiveExtubation failure in pediatric patients with congenital or acquired heart diseases increases morbidity and mortality. This study aimed to develop a clinical risk score for predicting extubation failure to guide proper clinical decision-making and management.MethodsWe conducted a retrospective study. This clinical prediction score was developed using data from the Pediatric Cardiac Intensive Care Unit (PCICU) of the Faculty of Medicine, Chiang Mai University, Thailand, from July 2016 to May 2022. Extubation failure was defined as the requirement for re-intubation within 48 h after extubation. Multivariable logistic regression was used for modeling. The score was evaluated in terms of discrimination and calibration.ResultsA total of 352 extubation events from 270 patients were documented. Among these, 40 events (11.36%) were extubation failure. Factors associated with extubation failure included history of pneumonia (OR: 4.14, 95% CI: 1.83–9.37, p = 0.001), history of re-intubation (OR: 5.99, 95% CI: 2.12–16.98, p = 0.001), and high saturation in physiologic cyanosis (OR: 5.94, 95% CI: 1.87–18.84, p = 0.003). These three factors were utilized to develop the risk score. The score showed acceptable discrimination with an area under the curve (AUC) of 0.77 (95% CI: 0.69–0.86), and good calibration.ConclusionThe derived Pediatric CMU Extubation Failure Prediction Score (Ped-CMU ExFPS) could satisfactorily predict extubation failure in pediatric cardiac patients. Employing this score could promote proper personalized care. We suggest conducting further external validation studies before considering implementation in practice.https://www.frontiersin.org/articles/10.3389/fped.2024.1346198/fullextubation failurepediatric cardiac patientscongenital heart diseaseacquired heart diseasepediatric cardiac intensive care unitprediction score for extubation failure |
| spellingShingle | Kwannapas Saengsin Kwannapas Saengsin Rekwan Sittiwangkul Thirasak Borisuthipandit Pakpoom Wongyikul Krittai Tanasombatkul Krittai Tanasombatkul Thanaporn Phanacharoensawad Guanoon Moonsawat Konlawij Trongtrakul Konlawij Trongtrakul Phichayut Phinyo Phichayut Phinyo Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit Frontiers in Pediatrics extubation failure pediatric cardiac patients congenital heart disease acquired heart disease pediatric cardiac intensive care unit prediction score for extubation failure |
| title | Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit |
| title_full | Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit |
| title_fullStr | Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit |
| title_full_unstemmed | Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit |
| title_short | Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit |
| title_sort | development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit |
| topic | extubation failure pediatric cardiac patients congenital heart disease acquired heart disease pediatric cardiac intensive care unit prediction score for extubation failure |
| url | https://www.frontiersin.org/articles/10.3389/fped.2024.1346198/full |
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