Development of a predictive model for failed extubation in patients with mechanical ventilation.

Methods A historical cohort study was conducted in a mixed intensive care unit with 40 beds at a University Centre. Patients analyzed were those admitted between 2010 and 2014, over the age of 16 years, with invasive mechanical ventilation for more than 24 hours and who overcome a spontaneous breath testing (SBT). Predictive variables: age, gender, days of intubation, length of intravenous sedation, cardiopulmonary diagnosis, BUN, creatinine, hemoglobin, PaO2/FIO2, PCO2, Glasgow scale, APACHE II, number of SBT, fluid balance 24 hours before extubation, cumulative fluids balance, positive culture of tracheal aspirate and use of inotropics before or during extubation. Failed extubation was defined as the need for invasive or non-invasive mechanical ventilation within the 48 hours after extubation. A multivariate logistic regression was fitted for predictive model selection, with assessment of discrimination by AUC-ROC and calibration by Hosmer-Lemeshow goodness-of-fit test.