目的：本研究旨在探討經急診途徑轉入之急性呼吸衰竭病人和計畫性拔管成功的相關性，並建立其計畫性拔管成功的預測因素。
方法：本研究採用回溯型病例研究，透過病歷、電腦登錄資料庫進行資料蒐集，以南部某醫學中心成人加護病房內，2018年1月1日至2018年12月31日自急診急性呼吸衰竭氣管插管後轉入並計畫性拔管之病人。統計分析方法使用描述性統計、卡方檢定、獨立樣本t檢定、二元羅吉斯迴歸分析。
結果：本研究共收案560位病人，拔管成功組有535位(95.5%)，失敗組有25位(4.5%)。研究結果發現兩組之間在插管原因(p=0.028)、是否安寧拔管(p=0.000)、拔管前昏迷指數(p=0.024)、拔管後昏迷指數(p=0.002)、拔管後呼吸次數(p=0.043)具有顯著差異。透過二元羅吉斯迴歸分析結果，僅有拔管後昏迷指數預測計畫性拔管成功具有顯著相關(勝算比=1.332, p=0.000)。
結論：本研究結果顯示急診停留時數在成功組和失敗組兩組中沒有顯著的相關性。急診途徑轉入之呼吸衰竭病人計畫性拔管成功率高達95.5%，拔管後昏迷指數在預測計畫性拔管成功具有顯著相關。 OBJECTIVE: This study was designed to investigate the association between patients with acute respiratory failure who were admitted to the emergency department and the successful planned endotracheal extubation, and to establish predictive factors for the success of planned endotracheal extubation.
METHODS: This study used a retrospective case study to collect data from medical records and computer accessed databases. In the adult intensive care unit of a medical center in the south, from January 1, 2018 to December 31, 2018, patients with respiratory failure transferred from the emergency department and planned endotracheal extubation. Statistical analysis methods used descriptive statistics, chi-square tests, independent sample t-tests, and binary logistic regression analysis.
RESULTS: A total of 560 patients were enrolled in the study. There were 535 patients (95.5%) in the successful group and 25 patients (4.5%) in the failed group. The results of the study found that the reason for intubation between the two groups (p = 0.028), whether compassionate extubation (p=0.000), the coma scale before extubation (p=0.024), the coma scale after extubation (p=0.002) and and respiratory rates after extubation (p=0.043) were significant differences. According to the results of the binary logistic regression analysis, only the coma scale after extubation predicted a significant correlation with the successful extubation (OR=1.332, p=0.020) .
CONCLUSION: The results of this study show that there was no significant difference in emergency stay time between the successful and failed groups. The successful rate of planned extubation in patients with respiratory failure transferred to the emergency department is as high as 95.5%. The coma scale after extubation was significantly associated with predicting the successful planned extubation.
