Liu K, Liu Z, Li LQ, Zhang M, Deng XX, Zhu H. Predictive value of the unplanned extubation risk assessment scale in hospitalized patients with tubes. World J Clin Cases 2022; 10(36): 13274-13283 [PMID: 36683639 DOI: 10.12998/wjcc.v10.i36.13274]
Corresponding Author of This Article
Hong Zhu, MD, RN, Professor, Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. zhuhong816@wchscu.cn
Research Domain of This Article
Nursing
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 26, 2022; 10(36): 13274-13283 Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13274
Predictive value of the unplanned extubation risk assessment scale in hospitalized patients with tubes
Kun Liu, Zheng Liu, Lin-Qian Li, Meng Zhang, Xue-Xue Deng, Hong Zhu
Kun Liu, Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
Zheng Liu, Lin-Qian Li, Meng Zhang, Xue-Xue Deng, Hong Zhu, Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Liu K and Zhu H contributed to the conception and design of the work, and to data acquisition and interpretation, data analysis and drafted the paper; Liu Z and Deng XX contributed to data acquisition and interpretation; Li LQ and Zhang M contributed to data analysis and assisted in interpretation and drafting the paper; All authors contributed to the critical reversion of the paper and approved the final manuscript for publication; All authors have agreed to be accountable for all aspects of the work. Liu K and Zhu H are responsible for the overall content as guarantors.
Supported byWest China Nursing Discipline Development Special Fund Project, Sichuan University, No. HXHL19059.
Institutional review board statement: Ethics approval was obtained from the Ethics Committee of the West China Hospital of Sichuan University (No.2022-512).
Informed consent statement: This study has been exempted from the informed consent application.
Conflict-of-interest statement: All the authors have no competing interests to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong Zhu, MD, RN, Professor, Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. zhuhong816@wchscu.cn
Received: September 7, 2022 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
ARTICLE HIGHLIGHTS
Research background
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.
Research motivation
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.
Research objectives
To assess the predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale in inpatients.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
Larger studies with multiple centers are needed to further confirm the prediction validity and generalization of the HUERAS.
