• Helena França Correia dos Reis, Mônica Lajana Oliveira Almeida, Mário Ferreira da Silva, and Mário de Seixas Rocha.
• Graduate Program in Medicine and Human Health, Bahia School of Medicine and Public Health, Federal University of Bahia, Salvador, Brazil. lenafran@gmail.com
• J Bras Pneumol. 2013 May 1;39(3):330-8.

ObjectiveTo evaluate the association between extubation failure and outcomes (clinical and functional) in patients with traumatic brain injury (TBI).MethodsA prospective cohort study involving 311 consecutive patients with TBI. The patients were divided into two groups according to extubation outcome: extubation success; and extubation failure (defined as reintubation within 48 h after extubation). A multivariate model was developed in order to determine whether extubation failure was an independent predictor of in-hospital mortality.ResultsThe mean age was 35.7 ± 13.8 years. Males accounted for 92.3%. The incidence of extubation failure was 13.8%. In-hospital mortality was 4.5% and 20.9% in successfully extubated patients and in those with extubation failure, respectively (p = 0.001). Tracheostomy was more common in the extubation failure group (55.8% vs. 1.9%; p < 0.001). The median length of hospital stay was significantly greater in the extubation failure group than in the extubation success group (44 days vs. 27 days; p = 0.002). Functional status at discharge was worse among the patients in the extubation failure group. The multivariate analysis showed that extubation failure was an independent predictor of in-hospital mortality (OR = 4.96; 95% CI, 1.86-13.22).ConclusionsIn patients with TBI, extubation failure appears to lengthen hospital stays; to increase the frequency of tracheostomy and of pulmonary complications; to worsen functional outcomes; and to increase mortality.

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