ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Risk factors for Failed Extubation Within 7 Days in Elderly Critically Ill Patients Based on Respiratory Mechanics and Clinical Indicators: A Retrospective Cohort Study
Provisionally accepted
- 1Zhejiang Hospital, Hangzhou, China
- 2Xinchang Hospital of Traditional Chinese Medicine, Xinchang, China
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Background Tracheal intubation and mechanical ventilation are common treatments for critically ill patients. Extubation failure is associated with prolonged mechanical ventilation, increased incidence of ventilator-associated pneumonia (VAP), and elevated mortality. Elderly patients face unique challenges. Thus, early risk assessment for weaning and extubation in elderly patients is crucial. This study aimed to identify independent risk factors for extubation failure within 7 days in elderly critically ill patients. Methods A retrospective cohort study was conducted on 103 elderly patients with tracheal intubation admitted to our ICU from January 2022 to July 2025. Clinical characteristics of patients with extubation failure within 7 days were analyzed. The optimal cutoff values for continuous variables were determined using the Youden index. Logistic regression analysis was performed to identify independent risk factors for extubation failure within 7 days. Results There was a high rate of extubation failure within 7 days in elderly critically ill patients. Logistic regression showed that female (OR=6.770, 95% CI 1.100-41.654, P=0.039), serum sodium >145.76 mmol/L (OR=15.008, 95% CI 1.189-189.465, P=0.036), lactate >3.45 mmol/L (OR=17.866, 95% CI 1.907-167.378, P=0.012), and peak airway pressure (Ppeak) >18.5 cmH₂O (OR=9.056, 95% CI 1.705-48.111, P=0.010) were positively correlated with extubation failure, serving as independent risk factors. Conclusion Female, serum sodium >145.76 mmol/L, lactate >3.45 mmol/L at intubation, and Ppeak >18.5 cmH₂O at relative stability after intubation are independent risk factors for extubation failure within 7 days in elderly patients with tracheal intubation.
Keywords: Elderly critical illness, tracheal extubation, Extubation failure, risk factor, Respiratory Mechanics
Received: 10 Oct 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Shen, Ruan, Zhang, Hu and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: YiKuan Shen, syk13588136392@163.com
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