Factors Associated with Early Extubation After Cardiac Surgery: A Retrospective Single-Centre Experience

Abstract Objectives: To identify factors associated with early extubation in cardiac surgery patients Design: Single centre, retrospective Setting: Tertiary university hospital Participants: 8872 adult patients who underwent cardiothoracic surgery from 2011-2019 Interventions: None Measurements and Main Results: Of the 8872 patients, 2950 (33%) were extubated within 6 hours post-operation. Early extubated patients were younger, had higher BMI, more likely to be male and fast-track designated. These patients more frequently underwent isolated coronary artery bypass graft, isolated valve or adult congenital surgeries than late extubated patients. Early extubated patients had higher incidence of coronary artery disease (CAD) and anxiety, and higher left ventricle ejection fraction. They were also less likely to have difficult intubation or require mechanical circulatory support, re-intubation or re-admission. Analysis of 8872 patients showed male sex (OR=1.222, 95% CI=1.096-1.363), BMI >30 kg/m2 (OR=1.702, 95% CI=1.475-1.965), having isolated valve surgery (OR=1.187, 95% CI=1.060-1.328), fast-track designation (OR=1.455, 95% CI=1.208-1.751) and CAD (OR=1.122, 95% CI=1.005-1.253) to be associated with early extubation. Data on ICU admission post-surgery were only available from 2014-2018. Within this sub-group of 5977 patients, variables associated with early extubation included male sex (OR=1.356, 95% CI=1.193-1.541), BMI >30 (OR=1.267, 95% CI=1.084-1.480), daytime admission to the ICU (OR=1.712, 95% CI=1.527-1.919), and fast-track designation (OR=1.423, 95% CI=1.123-1.802). Conclusions: Male sex, BMI >30, having isolated valve surgery, fast-track designation, CAD, and daytime admission to the ICU are associated with early extubation.