Clinical Outcomes & Complications of Endotracheal Intubation
Master of Public Health (MPH) Thesis Analysis
Dr. Imam Siddique Sahitya
2026-01-22
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# Import from live Google Sheet
url <- "[https://docs.google.com/spreadsheets/d/10EdmTHgJIxsBg1Qj5RIAS8vB3vHYl4J1cLd-y9Lj54o/edit?usp=sharing](https://docs.google.com/spreadsheets/d/10EdmTHgJIxsBg1Qj5RIAS8vB3vHYl4J1cLd-y9Lj54o/edit?usp=sharing)"
df <- gsheet2tbl(url) %>%
clean_names() %>%
# Cleaning data: Remove empty rows and trim text
filter(!is.na(patient_id)) %>%
mutate(across(where(is.character), str_trim))descriptive_tab <- df %>%
select(age, gender, icu_reason, icu_experience, sterilization) %>%
tbl_summary(
label = list(
age ~ "Age Group",
gender ~ "Gender",
icu_reason ~ "Reason for ICU Admission",
icu_experience ~ "Physician Experience Level",
sterilization ~ "Equipment Sterilization Method"
),
missing = "no"
) %>%
add_ci() %>% # Add 95% Confidence Intervals
bold_labels() %>%
modify_caption("**Table 1: Descriptive Statistics of the Study Population**")
descriptive_tab| Characteristic | N = 4061 | 95% CI |
|---|---|---|
| Age Group | ||
| 1. Newborn (0–30 days) | 15 (3.7%) | 2.2%, 6.2% |
| 2. Infant one month to one year | 29 (7.1%) | 4.9%, 10% |
| 3. Child (one to twelve years old) | 1 (0.2%) | 0.01%, 1.6% |
| 4. Adult between 13 and 50 years of age | 2 (0.5%) | 0.09%, 2.0% |
| 5. People over 50 years old | 70 (17%) | 14%, 21% |
| 6. Please indicate the age. | 12 (3.0%) | 1.6%, 5.2% |
| Infant, one month to one year | 89 (22%) | 18%, 26% |
| Newborn (0–30 days) | 29 (7.1%) | 4.9%, 10% |
| People over 50 years old | 148 (36%) | 32%, 41% |
| Please indicate the age. | 11 (2.7%) | 1.4%, 4.9% |
| Gender | ||
| Female | 188 (46%) | 41%, 51% |
| Male | 218 (54%) | 49%, 59% |
| Reason for ICU Admission | ||
| Cardiac arrest and after surgery recovery | 104 (26%) | 21%, 30% |
| Failure of respiratory systems | 86 (21%) | 17%, 26% |
| neurological disability | 52 (13%) | 9.8%, 17% |
| neurological disability; Other (please indicate) | 1 (0.2%) | 0.01%, 1.6% |
| Sepsis | 45 (11%) | 8.3%, 15% |
| Trauma—such as multiple injuries or cerebral damage | 118 (29%) | 25%, 34% |
| Physician Experience Level | ||
| five to ten years | 143 (35%) | 31%, 40% |
| less than five years | 125 (31%) | 26%, 36% |
| ten years or more | 138 (34%) | 29%, 39% |
| Equipment Sterilization Method | ||
| Absence of a methodical sterilizing plan | 169 (42%) | 37%, 47% |
| Absence of a methodical sterilizing plan; | 1 (0.2%) | 0.01%, 1.6% |
| Periodically cleaned | 109 (27%) | 23%, 31% |
| Strict compliance—autoclave after each usage | 127 (31%) | 27%, 36% |
| Abbreviation: CI = Confidence Interval | ||
| 1 n (%) | ||
ggplot(df, aes(x = age, fill = age)) +
geom_bar(show.legend = FALSE) +
geom_text(stat='count', aes(label=..count..), vjust=-0.5) +
labs(title = "Figure 1: Distribution of Patients by Age Group",
x = "Age Category", y = "Number of Patients") +
theme_minimal() +
theme(axis.text.x = element_text(angle = 45, hjust = 1))
# Visualizing the frequency of different intubation complications
df %>%
count(intubation_complication) %>%
ggplot(aes(x = reorder(intubation_complication, n), y = n)) +
geom_col(fill = "steelblue") +
coord_flip() +
labs(title = "Figure 2: Types of Intubation Complications Observed",
x = "Complication Type", y = "Frequency") +
theme_minimal()
##
df %>%
select(age, intubation_complication, cardiac_arrest) %>%
tbl_summary(
by = age,
label = list(intubation_complication ~ "Complication Type")
) %>%
add_p(test = all_categorical() ~ "fisher.test",
test.args = all_categorical() ~ list(simulate.p.value = TRUE)) %>%
bold_labels() %>%
modify_caption("**Table 2: Complications Categorized by Patient Age**")| Characteristic | 1. Newborn (0–30 days) N = 151 |
2. Infant one month to one year N = 291 |
3. Child (one to twelve years old) N = 11 |
4. Adult between 13 and 50 years of age N = 21 |
5. People over 50 years old N = 701 |
6. Please indicate the age. N = 121 |
Infant, one month to one year N = 891 |
Newborn (0–30 days) N = 291 |
People over 50 years old N = 1481 |
Please indicate the age. N = 111 |
p-value2 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Complication Type | 0.001 | ||||||||||
| Airway trauma (e.g. vocal cord damage lacerations) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 7 (10%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | |
| Airway trauma (e.g., vocal cord damage, lacerations) | 7 (47%) | 5 (17%) | 0 (0%) | 0 (0%) | 17 (24%) | 6 (50%) | 27 (30%) | 9 (31%) | 54 (36%) | 3 (27%) | |
| Desaturation during the process; o Cardiac arrest during intubation; other (please describe) | 0 (0%) | 3 (10%) | 0 (0%) | 0 (0%) | 5 (7.1%) | 4 (33%) | 9 (10%) | 7 (24%) | 22 (15%) | 1 (9.1%) | |
| Esophageal intubation | 6 (40%) | 5 (17%) | 0 (0%) | 0 (0%) | 9 (13%) | 0 (0%) | 17 (19%) | 5 (17%) | 16 (11%) | 2 (18%) | |
| Hemodynamic instability (e.g., hypotension, arrhythmia) | 0 (0%) | 10 (34%) | 0 (0%) | 0 (0%) | 13 (19%) | 1 (8.3%) | 18 (20%) | 2 (6.9%) | 24 (16%) | 3 (27%) | |
| Hypoxia | 2 (13%) | 6 (21%) | 1 (100%) | 2 (100%) | 19 (27%) | 1 (8.3%) | 18 (20%) | 6 (21%) | 32 (22%) | 2 (18%) | |
| cardiac_arrest | <0.001 | ||||||||||
| No cardiac arrest did not happen | 0 (0%) | 2 (6.9%) | 0 (0%) | 2 (100%) | 13 (19%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | |
| No, cardiac arrest did not happen | 7 (47%) | 17 (59%) | 0 (0%) | 0 (0%) | 40 (57%) | 8 (67%) | 71 (80%) | 22 (76%) | 122 (82%) | 8 (73%) | |
| Yes | 8 (53%) | 10 (34%) | 1 (100%) | 0 (0%) | 17 (24%) | 4 (33%) | 18 (20%) | 7 (24%) | 26 (18%) | 3 (27%) | |
| 1 n (%) | |||||||||||
| 2 Fisher’s Exact Test for Count Data with simulated p-value (based on 2000 replicates) | |||||||||||
df %>%
select(checklist_compliance, intubation_complication, intubation_success) %>%
tbl_summary(
by = checklist_compliance,
label = list(intubation_complication ~ "Complication Type",
intubation_success ~ "First-Pass Success Rate")
) %>%
add_p(test = all_categorical() ~ "chisq.test") %>%
add_overall() %>%
modify_caption("**Table 3: Safety Outcomes by Protocol Compliance**")| Characteristic | Overall N = 4051 |
Absence of a systematic procedure N = 291 |
Adherence to procedures N = 351 |
Consistently adhered to N = 1131 |
o. Consistently adhered to N = 61 |
o. Occasionally adhered to N = 21 |
Occasionally adhered to N = 1431 |
Seldom or never adhered to N = 771 |
p-value2 |
|---|---|---|---|---|---|---|---|---|---|
| Complication Type | <0.001 | ||||||||
| Airway trauma (e.g. vocal cord damage lacerations) | 7 (1.7%) | 0 (0%) | 0 (0%) | 1 (0.9%) | 2 (33%) | 1 (50%) | 2 (1.4%) | 1 (1.3%) | |
| Airway trauma (e.g., vocal cord damage, lacerations) | 128 (32%) | 13 (45%) | 7 (20%) | 31 (27%) | 0 (0%) | 0 (0%) | 50 (35%) | 27 (35%) | |
| Desaturation during the process; o Cardiac arrest during intubation; other (please describe) | 51 (13%) | 7 (24%) | 6 (17%) | 15 (13%) | 0 (0%) | 0 (0%) | 13 (9.1%) | 10 (13%) | |
| Esophageal intubation | 60 (15%) | 4 (14%) | 4 (11%) | 16 (14%) | 0 (0%) | 0 (0%) | 19 (13%) | 17 (22%) | |
| Hemodynamic instability (e.g., hypotension, arrhythmia) | 71 (18%) | 2 (6.9%) | 11 (31%) | 15 (13%) | 0 (0%) | 0 (0%) | 30 (21%) | 13 (17%) | |
| Hypoxia | 88 (22%) | 3 (10%) | 7 (20%) | 35 (31%) | 4 (67%) | 1 (50%) | 29 (20%) | 9 (12%) | |
| First-Pass Success Rate | 0.5 | ||||||||
| 85% or more first-pass intubation success rate | 7 (88%) | 0 (NA%) | 0 (NA%) | 0 (NA%) | 6 (100%) | 1 (50%) | 0 (NA%) | 0 (NA%) | |
| Less than 50% | 1 (13%) | 0 (NA%) | 0 (NA%) | 0 (NA%) | 0 (0%) | 1 (50%) | 0 (NA%) | 0 (NA%) | |
| Unknown | 397 | 29 | 35 | 113 | 0 | 0 | 143 | 77 | |
| 1 n (%) | |||||||||
| 2 Pearson’s Chi-squared test | |||||||||
df %>%
select(icu_experience, intubation_success, cardiac_arrest) %>%
tbl_summary(
by = icu_experience,
label = list(intubation_success ~ "Success Status",
cardiac_arrest ~ "Cardiac Arrest during Procedure")
) %>%
add_p(test = all_categorical() ~ "fisher.test",
test.args = all_categorical() ~ list(simulate.p.value = TRUE)) %>%
modify_caption("**Table 4: Relationship between Experience and Procedural Success**")| Characteristic | five to ten years N = 1431 |
less than five years N = 1251 |
ten years or more N = 1381 |
p-value2 |
|---|---|---|---|---|
| Success Status | 0.6 | |||
| 85% or more first-pass intubation success rate | 2 (100%) | 2 (67%) | 4 (100%) | |
| Less than 50% | 0 (0%) | 1 (33%) | 0 (0%) | |
| Unknown | 141 | 122 | 134 | |
| Cardiac Arrest during Procedure | 0.8 | |||
| No cardiac arrest did not happen | 4 (2.8%) | 6 (4.8%) | 7 (5.1%) | |
| No, cardiac arrest did not happen | 109 (76%) | 88 (70%) | 98 (71%) | |
| Yes | 30 (21%) | 31 (25%) | 33 (24%) | |
| 1 n (%) | ||||
| 2 Fisher’s Exact Test for Count Data with simulated p-value (based on 2000 replicates) | ||||