Incidence and Outcome of Reintubation in the PACU

Study Overview
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Brief Summary
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This study evaluated the occurrence of reintubation after planned extubation (RAP), the impact of RAP on duration of PACU stay,length of stay,length of postoperative stay,inpatient healthcare costs, unanticipated ICU admission and readmission.

Detailed Description
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The study was carried out in Wuhan City, China at a general public university hospital with 62 clinical departments, 99 surgical rooms, and 38 beds in the PACU. The total number of operations performed in this hospital is more than 90,000/year. The study was approved by the hospital ethics committee and was deemed that written patient consent was not required. The adverse events, including RAP, in all patients in the PACU were recorded on a standardized form in a database by pre-trained qualified nurses and/or anesthesiologists at the time of care from January 1, 2017 to December 31, 2019. Data, including patient demographic and surgical and anesthesia parameters, were obtained from the anesthesia information system. Adverse events management and duration of PACU stay were also documented. For three years, all collected data were filed in a computer every day and were summarized and analyzed every month. Data, such as demographics, airway, oxygen saturation, consciousness, treatment, vital signs, and fast-track criteria scores, were recorded for all patients in the PACU. The first part contained preoperative and intraoperative data, which were entered into the database by the anesthesiologists involved in the patients' intraoperative care from the time of PACU admission. The second part were recorded by nurse and comprised postoperative data from the PACU to the ward or ICU. The third part were recorded by the surgeons and/ or surgical nurses and comprised postoperative data. The criteria for tracheal extubation in the operating room(OR) and the timing of transfer to the PACU were the responsibility of the anesthesiologist.

Official Title
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Incidence and Outcome of Reintubation in the Postanesthesia Care Unit: a Single-center, Retrospective, Observational Matched Cohort Study in China

Conditions
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Postoperative Complications, Complication of Medical Care

Intervention / Treatment
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* Procedure: repeat endotracheal intubation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients requiring stay in PACU Exclusion Criteria: Patients were transferred directly from the operating room to the ward or icu non-postoperative patient
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Reintubation after planned extubation<br>Reintubation after planned extubation(RAP) was defined as repeat endotracheal intubation in the PACU after planned extubation of the initial endotracheal intubation for general anesthesia or combined general anesthesia other than that performed in the operating room. | Procedure: repeat endotracheal intubation<br>* repeat endotracheal intubation in the PACU after planned extubation of the initial endotracheal intubation for general anesthesia or combined general anesthesia other than that performed in the operating room<br>|
| matched group<br>Patients without RAP during the PACU stay were designated as the matched group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of PACU stay | From patient transfer into PACU to transfer out of PACU | through study completion, an average of three months | 
| Length of postoperative stay |  | through study completion, an average of three months | 
| Unanticipated ICU admission | Unplanned transfer to the ICU | through study completion, an average of three months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Inpatient healthcare costs | Any medical cost during hospital stay | through study completion, an average of three months | 
| Length of stay | The time of hospital length of stay | through study completion, an average of three months | 
| Duration of postoperative monitoring | The time of postoperative monitoring | through study completion, an average of three months | 
| Readmission | admission after hospital discharge | through study completion, an average of three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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general anesthesia, postanesthesia care unit, reintubation after planned extubation