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Self-extubation Laryngeal Injuries at an Academic Tertiary Care Center: A Retrospective Pilot Study
Journal article   Peer reviewed

Self-extubation Laryngeal Injuries at an Academic Tertiary Care Center: A Retrospective Pilot Study

Jason E Cohn, Andrew Touati, Mark Lentner, Mark Weitzel, Casey Fisher and Robert T Sataloff
Annals of otology, rhinology & laryngology, v 126(7), pp 555-560
Jul 2017
DOI: https://doi.org/10.1177/0003489417709795
PMID: 28503976
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Adult Aged Aged, 80 and over Airway Extubation - adverse effects Dysphonia - diagnosis Dysphonia - etiology Female Hoarseness - diagnosis Hoarseness - etiology Humans Intensive Care Units Intubation, Intratracheal Laryngeal Edema - diagnosis Laryngeal Edema - etiology Laryngoscopy Larynx - injuries Male Middle Aged Pilot Projects Retrospective Studies Severity of Illness Index Tertiary Care Centers Time Factors
The purpose of this study is to identify laryngeal symptoms and injuries in self-extubated patients. A retrospective chart review was conducted to identify symptoms and clinical findings associated with self-extubation. A novel scoring system was developed and used to quantify these findings. Symptom score included all symptoms that patients reported after self-extubation. Clinical score consisted of laryngeal findings visualized on nasopharyngeal laryngoscopy. Finally, a total self-extubation score was calculated as the sum of the symptom and clinical scores. Additionally, duration of intubation and endotracheal tube size were correlated with these scores. Sixty (n = 60) patients who self-extubated in our institution's intensive care unit were identified. Average calculated symptom, clinical, and total self-extubation scores were 0.92, 1.43, and 2.35, respectively. The most common symptom observed was hoarseness (62%), while the most common clinical finding was posterior laryngeal edema (58%). A significant positive correlation was found between duration of intubation and both symptom score and total self-extubation score (r = 0.314, P = .008 and r = 0.223, P = .05, respectively). Symptom score predicted clinical score with a significant positive correlation present (r = 0.278, P = .02). This study demonstrates that the majority of self-extubated patients have laryngeal symptoms and clinical findings. A comprehensive, multidisciplinary evaluation is warranted for self-extubations.

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Collaboration types
Domestic collaboration
Web of Science research areas
Otorhinolaryngology
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