Overnight Extubation: Is It Worth the Risk?

​Overnight extubation is associated with a significantly higher risk of hospital mortality, compared with daytime extubation, according to an original investigation published in the November 2016 issue of JAMA Internal Medicine. Overnight extubation is relatively uncommon, and little is known about the risks associated with it. The authors conducted a retrospective cohort study of 97,844 adults undergoing mechanical ventilation in intensive care units (ICUs) at 165 hospitals between October 1, 2000, and March 29, 2009. Approximately one-fifth (20.1%) of the population studied underwent overnight extubation. Those patients had significantly higher rates of ICU mortality (5.6% versus 4.6% for intubations lasting less than 12 hours; 11.2% versus 6.1% for intubations lasting 12 hours or longer) and hospital mortality (8.3% versus 7.0% for intubations lasting less 12 hours; 16.0% versus 11.1% for intubations of 12 hours or longer) than those who underwent daytime extubation.