title: Semiquantitative cough strength score for predicting reintubation after planned extubation.
abstract: BACKGROUND
  Semiquantitative cough strength score (SCSS, graded 0-5) and cough peak flow (CPF) have been used to predict extubation outcome in patients in whom extubation is planned; however, the correlation of the 2 assessments is unclear.
  
  
  METHODS
  In the intensive care unit of a university-affiliated hospital, 186 patients who were ready for extubation after a successful spontaneous breathing trial were enrolled in the study. Both SCSS and CPF were assessed before extubation. Reintubation was recorded 72 hours after extubation.
  
  
  RESULTS
  Reintubation rate was 15.1% within 72 hours after planned extubation. Patients in whom extubation was successful had higher SCSSs than did reintubated patients (mean [SD], 3.2 [1.6] vs 2.2 [1.6], P = .002) and CPF (74.3 [40.0] vs 51.7 [29.4] L/min, P = .005). The SCSS showed a positive correlation with CPF (r = 0.69, P < .001). Mean CPFs were 38.36 L/min, 39.51 L/min, 44.67 L/min, 57.54 L/min, 78.96 L/min, and 113.69 L/min in patients with SCSSs of 0, 1, 2, 3, 4, and 5, respectively. The discriminatory power for reintubation, evidenced by area under the receiver operating characteristic curve, was similar: 0.677 for SCSS and 0.678 for CPF (P = .97). As SCSS increased (from 0 to 1 to 2 to 3 to 4 to 5), the reintubation rate decreased (from 29.4% to 25.0% to 19.4% to 16.1% to 13.2% to 4.1%).
  
  
  CONCLUSIONS
  SCSS was convenient to measure at the bedside. It was positively correlated with CPF and had the same accuracy for predicting reintubation after planned extubation.
authors.affiliation: Jun Duan and Lintong Zhou are physicians and Meiling Xiao, Jinhua Liu, and Xiangmei Yang are nurses in the Department of Respiratory Medicine at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China. duanjun412589@163.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Duan
authors.affiliation: Jun Duan and Lintong Zhou are physicians and Meiling Xiao, Jinhua Liu, and Xiangmei Yang are nurses in the Department of Respiratory Medicine at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Lintong
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Jun Duan and Lintong Zhou are physicians and Meiling Xiao, Jinhua Liu, and Xiangmei Yang are nurses in the Department of Respiratory Medicine at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Meiling
authors.initials: M
authors.lastname: Xiao
authors.affiliation: Jun Duan and Lintong Zhou are physicians and Meiling Xiao, Jinhua Liu, and Xiangmei Yang are nurses in the Department of Respiratory Medicine at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Liu
authors.affiliation: Jun Duan and Lintong Zhou are physicians and Meiling Xiao, Jinhua Liu, and Xiangmei Yang are nurses in the Department of Respiratory Medicine at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Xiangmei
authors.initials: X
authors.lastname: Yang
mesh_terms: D000368:Aged; D060666:Airway Extubation / Q000706:statistics & numerical data*; D003371:Cough / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data*; D008297:Male; D015203:Reproducibility of Results; D015656:Respiratory Mechanics / Q000502:physiology*; D019233:Retreatment; D012680:Sensitivity and Specificity; D015300:Ventilator Weaning / Q000706:statistics & numerical data