Evidence map›Paper›PMID 31082359›Full record

ArticleThe Annals of thoracic surgery2019

Association of Overnight Extubation With Outcomes After Cardiac Surgery in the Intensive Care Unit.

Hayley B Gershengorn, Hannah Wunsch, May Hua, Joseph E Bavaria, Jacob Gutsche

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Annals of thoracic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
  2. Article
  3. New Opioid Use after Invasive Mechanical Ventilation and Hospital Discharge.American journal of respiratory and critical care medicine · 2020
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Hayley B GershengornDivision of Pulmonary, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida; Division of Critical Care Medicine, Albert Einstein College of Medicine, Bronx, New York. Electronic address: hbg20@med.miami.edu.
Hannah WunschDepartment of Anesthesia and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Anesthesiology, Columbia University Medical College, New York, New York.
May HuaDepartment of Anesthesiology, Columbia University Medical College, New York, New York; Department of Epidemiology, Columbia University Medical College, New York, New York.
Joseph E BavariaDivision of Cardiothoracic Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Jacob GutscheDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
University of Pennsylvania · USColumbia University Irving Medical Center · USUniversity of Miami · USUniversity of Toronto · CA

Funding

Determinants of Critical Care Intensity for Hospitalized Older Adults: the Effect of Hospital-based Palliative Care ServicesK08AG051184 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI HUA, MAY · 2015 to 2019
$863k
NIA NIH HHS K08 AG051184NIA NIH HHS L30 AG053861
6 · The paper itself

Abstract

backgroundThe frequency and safety of overnight extubation (OE) after cardiac surgery across intensive care units (ICUs) is unknown.

methodsWe performed a retrospective study of adults (≥ 18 years) in US ICUs after coronary artery bypass grafting (CABG) or aortic valve replacement (AVR) or both, using The Society of Thoracic Surgery Adult Cardiac Surgery Database (July 2014 to June 2017); our primary cohort was elective CABGs. We assessed OE (7:00 pm to 6:59 am) frequency and used multilevel regression modelling to identify factors associated with OE. Within mechanical ventilation (MV) duration strata, we used propensity score matching to evaluate associations of OE with reintubations (primary outcome), mortality, and complications.

resultsAmong 142,225 patients with elective CABG, 42.2% had OEs. MV duration, cardiopulmonary bypass time, distal anastomosis number, and hospital of admission (median odds ratio [OR] 1.82, 95% confidence interval [CI]: 1.76 to 1.89) were independently associated with OE. After propensity matching, OE was associated with increased reintubation for patients with MV duration of 6 to 8 hours (2.2% vs 1.7%, OR 1.27, 95% CI: 1.04 to 1.56) and decreased reintubation for patients with MV duration of 15 to 17 hours (3.0% vs 4.2%, OR 0.70, 95% CI: 0.50 to 0.97) and 18 to 20 hours (2.3% vs 5.7%, OR 0.39, 95% CI: 0.21 to 0.72); OE was associated with increased ICU length of stay for patients with MV duration of 6 to 8 hours, but reduced length of stay for patients with MV duration of 9 to 20 hours. OE was not associated with increased mortality (hospital, 30-day). Other groups had similar OE rates (nonelective CABGs, 47.6%; elective AVR, 36.0%; elective CABG + AVRs, 51.0%) and outcomes.

conclusionsOE is prevalent after cardiac surgery. OE is associated with little risk and reduces ICU length of stay for patients who require MV for more than 8 hours.

Indexed as

Cardiac Surgical ProceduresIntensive Care UnitsAgedAirway ExtubationFemaleHospital MortalityHumansIncidenceLength of StayMalePostoperative CarePostoperative ComplicationsRespiration, ArtificialRetrospective StudiesSurvival RateUnited States

Identifiers

PMID31082359
PMCPMC6736599
OpenAlexW2944445357

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.