When compared to daytime extubations on intensive care unit patients, extubations performed at night have higher rates of mortality, according to a study published in JAMA Internal Medicine.
Researchers studied outcomes of 97,844 patients who underwent mechanical ventilation across 165 ICUs from October 2000 through March 2009. "Overnight" extubations occurred between 7 p.m. and 6:59 a.m.
Roughly 20 percent of the analyzed patients underwent an overnight extubation. When the mechanical ventilation lasted less than 12 hours, reintubation rates were similar for daytime and overnight extubations, according to the study, but mortality increased for overnight extubation patients, both in the ICU (5.6 percent versus 4.6 percent) and the hospital (8.3 percent versus 7 percent).
For ventilation that lasted at least 12 hours, overnight extubation patients had more frequent reintubation in the ICU and higher mortality in the ICU (11.2 percent versus 6.1 percent) and the hospital (16 percent versus 11.1 percent).
"Further studies are needed to understand why overnight extubation results in poorer outcomes," the study concludes.