Airway management and functional outcomes in intubated patients with ischemic stroke
Abstract We investigated the functional outcomes in ischemic stroke patients who underwent endotracheal intubation according to airway management (i.e., extubation success, extubation failure, primary tracheostomy) at multiple time points. Patients were classified into three groups: extubation succe...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-01-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-85489-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841544829769613312 |
|---|---|
| author | Jae Wook Jung Ilmo Kang Jin Park Sang-Beom Jeon |
| author_facet | Jae Wook Jung Ilmo Kang Jin Park Sang-Beom Jeon |
| author_sort | Jae Wook Jung |
| collection | DOAJ |
| description | Abstract We investigated the functional outcomes in ischemic stroke patients who underwent endotracheal intubation according to airway management (i.e., extubation success, extubation failure, primary tracheostomy) at multiple time points. Patients were classified into three groups: extubation success, extubation failure, and primary tracheostomy. Their functional outcomes were compared at hospital discharge, 3-month, and 1-year. Out of 165 ischemic stroke patients, 84 (50.9%) underwent extubation attempt and 81 (49.1%) underwent primary tracheostomy. Among the patients who underwent extubation, 26 (31.0%) experienced extubation failure. The extubation success group had a higher rate of achieving a favorable functional outcome (modified Rankin Scale 0–4) compared to the extubation failure group at hospital discharge (adjusted odds ratio [aOR] 3.93; 95% CI, 1.33–13.1; p = 0.018) and at 3-month (aOR 5.67; 95% CI 1.79–19.8; p = 0.004), but not at 1-year (aOR 2.99; 95% CI 0.96–9.68; p = 0.061). The primary tracheostomy group had a significantly lower rate of achieving a favorable functional outcome at all time points compared to the extubation failure group. These findings suggest that a condition suitable for an extubation attempt may be a more important 1-year prognostic indicator than extubation failure. Despite its limitations, this study suggests that the clinical condition prompting primary tracheostomy may outweigh extubation failure as a determinant of 1-year prognosis. However, prospective studies are needed to validate it and clarify its clinical implications. |
| format | Article |
| id | doaj-art-8f9eef4b50fb4beb991604f2fab98cf7 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-8f9eef4b50fb4beb991604f2fab98cf72025-01-12T12:17:02ZengNature PortfolioScientific Reports2045-23222025-01-0115111010.1038/s41598-025-85489-yAirway management and functional outcomes in intubated patients with ischemic strokeJae Wook Jung0Ilmo Kang1Jin Park2Sang-Beom Jeon3Department of Neurology, Asan Medical Center, University of Ulsan College of MedicineDepartment of Neurology, Asan Medical Center, University of Ulsan College of MedicineDepartment of Neurology, Asan Medical Center, University of Ulsan College of MedicineDepartment of Neurology, Asan Medical Center, University of Ulsan College of MedicineAbstract We investigated the functional outcomes in ischemic stroke patients who underwent endotracheal intubation according to airway management (i.e., extubation success, extubation failure, primary tracheostomy) at multiple time points. Patients were classified into three groups: extubation success, extubation failure, and primary tracheostomy. Their functional outcomes were compared at hospital discharge, 3-month, and 1-year. Out of 165 ischemic stroke patients, 84 (50.9%) underwent extubation attempt and 81 (49.1%) underwent primary tracheostomy. Among the patients who underwent extubation, 26 (31.0%) experienced extubation failure. The extubation success group had a higher rate of achieving a favorable functional outcome (modified Rankin Scale 0–4) compared to the extubation failure group at hospital discharge (adjusted odds ratio [aOR] 3.93; 95% CI, 1.33–13.1; p = 0.018) and at 3-month (aOR 5.67; 95% CI 1.79–19.8; p = 0.004), but not at 1-year (aOR 2.99; 95% CI 0.96–9.68; p = 0.061). The primary tracheostomy group had a significantly lower rate of achieving a favorable functional outcome at all time points compared to the extubation failure group. These findings suggest that a condition suitable for an extubation attempt may be a more important 1-year prognostic indicator than extubation failure. Despite its limitations, this study suggests that the clinical condition prompting primary tracheostomy may outweigh extubation failure as a determinant of 1-year prognosis. However, prospective studies are needed to validate it and clarify its clinical implications.https://doi.org/10.1038/s41598-025-85489-yCerebral infarctionIntubationNeurocritical careExtubation failureIntensive care unit |
| spellingShingle | Jae Wook Jung Ilmo Kang Jin Park Sang-Beom Jeon Airway management and functional outcomes in intubated patients with ischemic stroke Scientific Reports Cerebral infarction Intubation Neurocritical care Extubation failure Intensive care unit |
| title | Airway management and functional outcomes in intubated patients with ischemic stroke |
| title_full | Airway management and functional outcomes in intubated patients with ischemic stroke |
| title_fullStr | Airway management and functional outcomes in intubated patients with ischemic stroke |
| title_full_unstemmed | Airway management and functional outcomes in intubated patients with ischemic stroke |
| title_short | Airway management and functional outcomes in intubated patients with ischemic stroke |
| title_sort | airway management and functional outcomes in intubated patients with ischemic stroke |
| topic | Cerebral infarction Intubation Neurocritical care Extubation failure Intensive care unit |
| url | https://doi.org/10.1038/s41598-025-85489-y |
| work_keys_str_mv | AT jaewookjung airwaymanagementandfunctionaloutcomesinintubatedpatientswithischemicstroke AT ilmokang airwaymanagementandfunctionaloutcomesinintubatedpatientswithischemicstroke AT jinpark airwaymanagementandfunctionaloutcomesinintubatedpatientswithischemicstroke AT sangbeomjeon airwaymanagementandfunctionaloutcomesinintubatedpatientswithischemicstroke |