[Risk factors for deliberate self-extubation].
OBJECTIVE
This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation.


METHODS
Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model.


RESULTS
Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients).


CONCLUSIONS
Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.
Surgical Intensive Care Unit, Kosin University Gospel Hospital, Busan, Korea.
Young Shin
YS
Cho
Department of Nursing, Dong-A University, Busan, Korea. jheeyeo@dau.ac.kr.
Jung Hee
JH
Yeo
D000367:Age Factors; D000368:Aged; D003243:Consciousness; D020878:Device Removal; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000401:mortality / Q000451:nursing* / Q000523:psychology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000706:statistics & numerical data / Q000600:supply & distribution; D016016:Proportional Hazards Models; D011595:Psychomotor Agitation; D012189:Retrospective Studies; D012307:Risk Factors; D016526:Workload
D006993:Hypnotics and Sedatives
Airway extubation; Intensive care units; Survival analysis