Predictive value of the unplanned extubation risk assessment scale in hospitalized patients with tubes

Table 1 Scoring method of the Huaxi Unplanned Extubation Risk Assessment Scale

Characteristics	Options	Scoring
Age	14-65 years old/< 14 or ≥ 65 years old	1/2
State of consciousness	Medium or deep coma/Awake/Lethargy, light coma, or drowsiness/Blurred consciousness, irritability, or delirium	1/2/3/4
Degree of understanding	Understanding, newborn or deep sedation/Partial understanding/Incomprehension	1/2/3
Emotional state	Stable or deep sedation/Sometimes stable/Unstable	1/2/3
Degree of cooperation	Cooperative/Sometimes cooperative/Uncooperative	1/2/3
Tolerance degree of tubes	Tolerable/Pain or discomfort, but basically tolerable/Pain or discomfort leads to intolerance of the tube	1/2/3
Number of tubes	1/2-3/3 or more	1/2/3
Type of tubes	PICC; CVC, Jejunostomy, Splittable catheter, Pericardial drainage tube, Abdominal wound drainage tube, Bladder and kidney fistulas, Perirenal drainage tube; Tracheotomy tube, Closed thoracic drainage tube, Urinary catheter, Gastric tube, Nasointestinal canal, Double capsule three lumen tube, Radial artery puncture tube, Internal jugular vein puncture tube, Lumbar cistern drainage tube, Ventricular drainage tube and other head drainage tubes, Cervical plasma drainage tube, Breast plasma drainage tube; Oronasal endotracheal intubation	1/2/3/4
Fixation mode of tubes	Suture/Holder, water bag, airbag, or tie wrap/Adhesive tape	1/2/3
Activity ability	Autonomous activity/Using walking aids, unstable walking, or need help/Absolute bed rest	0/1/2

PICC: Peripherally inserted central catheter; CVC: Central venous catheter.

Table 2 The characteristics of participants (n = 76033)

Character	Category	n	Percentage (%)
Sex	Male	39559	52.03
	Female	36474	47.97
Admission mode	Emergency admission	8009	10.53
	Outpatient admission	68024	89.47
Education	Master and above	1477	1.94
	University	10226	13.45
	College	9715	12.78
	Senior school, or Secondary specialized school	13240	17.41
	Junior high school	20063	26.39
	Primary school	14810	19.48
	Preschool, or illiteracy	6502	8.55
Marital status	Unmarried	8538	11.23
	Married	62902	82.73
	Divorced	1682	2.21
	Widowed	1894	2.49
	Others	1017	1.34
Number of tubes	1	41707	54.85
	2-3	22781	29.96
	> 3	11545	15.18
Discharge mode	Discharged according to doctor’s order	69284	91.12
	Voluntary discharge	2216	2.91
	Death	1041	1.37
	Transfer to another hospital	3326	4.37
	Others	166	0.22

Table 3 Basic information of unplanned extubation events (n = 26)

Characteristic	Category	n	Percentage (%)
Sex	Male	22	84.62
	Female	4	15.38
Number of indwelling tubes	1	5	19.23
	2-3	9	34.62
	> 3	12	46.15
Date type	Weekdays	24	92.31
	Weekend & holidays	2	7.69
Department type	Internal medicine	13	50.00
	Surgery	11	42.31
	ICU	2	7.69
Occurrence time	Day (8:00-18:00)	7	26.92
	Night (18:00-next day 8:00)	19	73.08
Type of tube extubation	Deep venous catheter (PICC & CVC)	8	30.77
	Urinary catheter	5	19.23
	Drainage tube	5	19.23
	Orogastric tube/Nasointestinal canal	4	15.38
	Endotracheal intubation	3	11.54
	Nasogastric tube & drainage tube	1	3.85
Circumstance of unplanned extubation events	In bed	20	76.92
	During transportation	3	11.54
	Moving out of bed	2	7.69
	Improper operation by medical staff	1	3.85

PICC: Peripherally inserted central catheter; CVC: Central venous catheter; ICU: Intensive care unit.

Table 4 The correlation coefficient between each characteristic and the total score

Characteristic	r	P value
Age	0.299	0.000
State of consciousness	0.632	0.000
Degree of understanding	0.814	0.000
Emotional state	0.780	0.000
Degree of cooperation	0.843	0.000
Tolerance degree of tubes	0.653	0.000
Number of tubes	0.724	0.000
Type of tubes	0.684	0.000
Fixation mode of tubes	0.435	0.000
Activity ability	0.183	0.000

Table 5 Sensitivity and specificity corresponding to each cutoff value of Huaxi Unplanned Extubation Risk Assessment Scale

Cutoff	Sensitivity	1-specificity	Specificity	Youden indexa
10.0000	1.000	1.000	0	0
11.5000	1.000	1.000	0	0
12.5000	1.000	0.996	0.004	0.004
13.5000	1.000	0.932	0.068	0.068
14.5000	0.962	0.735	0.265	0.227
15.5000	0.962	0.601	0.399	0.361
16.5000	0.923	0.448	0.552	0.475
17.5000	0.885	0.335	0.665	0.55
18.5000	0.885	0.260	0.74	0.625
19.5000	0.846	0.219	0.781	0.627
20.5000	0.846	0.186	0.814	0.66
21.5000	0.769	0.157	0.843	0.612
22.5000	0.692	0.122	0.878	0.57
23.5000	0.500	0.093	0.907	0.407
24.5000	0.346	0.066	0.934	0.28
25.5000	0.115	0.045	0.955	0.07
26.5000	0.077	0.032	0.968	0.045
27.5000	0.038	0.018	0.982	0.02
28.5000	0.000	0.007	0.993	-0.007
29.5000	0.000	0.001	0.999	-0.001
31.0000	0.000	0.000	1	0

^aYouden index = sensitivity + specificity - 1.