# Single Versus Shared ICU Rooms and the Risk of Unplanned Extubation: A Real-World Cohort Showing Tube Displacement as an Early Signal

## TL;DR

This study found that patients in single ICU rooms had a higher risk of unplanned extubation compared to those in shared rooms, with tube displacement serving as an early warning sign.

## Contribution

The study identifies tube displacement as an early signal for unplanned extubation and shows that ICU room configuration may influence extubation risk.

## Key findings

- Unplanned extubation occurred in 13.6% of patients and was significantly more frequent in single rooms.
- Tube displacement was significantly associated with unplanned extubation.
- Extubation failure correlated with increased hospital and ICU mortality.

## Abstract

Background: Unplanned extubation (UE) is a critical adverse event in intensive care units (ICUs) that can result in severe complications and increased mortality. Environmental factors, such as room configuration, may influence this risk but remain understudied. This study aimed to evaluate the association between ICU room type (single vs. shared) and the occurrence of UE in mechanically ventilated patients.

Methods: This was a retrospective cohort study conducted at the Hospital de Clínicas, University of Campinas, Brazil, including 118 adult patients admitted between March 2023 and March 2024. Variables analyzed included age, sex, Simplified Acute Physiology Score 3 (SAPS 3) score, room type, extubation type (planned vs. unplanned), tube displacement, extubation failure (reintubation ≤48 hours), hospital mortality, ICU mortality, and ventilator-associated pneumonia. Statistical analyses used chi-square, Fisher’s exact, Student’s t, and Mann-Whitney U tests, with a significance level of p < 0.05.

Results: Of 118 patients, 54.3% were men, with a mean age of 56.8 years and a mean SAPS 3 score of 76.4. Forty-five patients (38.1%) were admitted to single rooms and 73 (61.9%) to shared rooms. UE occurred in 13.6% of cases and was significantly more frequent in single rooms (p = 0.031). Tube displacement was associated with UE (p = 0.016), and extubation failure correlated with increased hospital (p = 0.006) and ICU mortality (p = 0.019).

Conclusions: Room type influenced extubation patterns but did not affect major clinical outcomes. Tube displacement was identified as an early marker for UE risk, emphasizing the need for continuous monitoring and preventive strategies.