• Quynh Nguyen, Kevin Coghlan, Yongzhe Hong, Jeevan Nagendran, Roderick MacArthur, and Wing Lam.
• Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Mazankowski Alberta Heart Institute, Edmonton, Canada.
• J. Cardiothorac. Vasc. Anesth. 2021 Jul 1; 35 (7): 1964-1970.

ObjectivesTo identify factors associated with early extubation in cardiac surgery patients.DesignSingle center, retrospective.SettingTertiary university hospital.ParticipantsThe study comprised 8,872 adult patients who underwent cardiothoracic surgery from 2011-2019.InterventionsNone.Measurements And Main ResultsOf the 8,872 patients, 2,950 (33%) were extubated within six hours after surgery. Early extubated patients were younger, had a higher body mass index (BMI), were more likely to be male, and were fast-track designated. These patients more frequently underwent isolated coronary artery bypass graft, isolated valve, or adult congenital surgeries than did late extubated patients. Early extubated patients had a greater incidence of coronary artery disease (CAD) and anxiety and a higher left ventricular ejection fraction. They also were less likely to have difficult intubation or require mechanical circulatory support, reintubation, or readmission. Analysis of the 8,872 patients showed that male sex (odds ratio [OR] 1.222, 95% confidence interval [CI] 1.096-1.363), a BMI >30 kg/m2 (OR 1.702, 95% CI 1.475-1.965), undergoing isolated valve surgery (OR 1.187, 95% CI 1.060-1.328), and having a fast-track designation (OR 1.455, 95% CI 1.208-1.751) and CAD (OR 1.122, 95% CI 1.005-1.253) were associated with early extubation. Data on intensive care unit (ICU) admission after surgery were available only from 2014-2018. Within this subgroup of 5,977 patients, variables associated with early extubation included male sex (OR 1.356, 95% CI 1.193-1.541), BMI >30 kg/m2 (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).ConclusionsMale sex; a BMI >30 kg/m2; undergoing isolated valve surgery; and having a fast-track designation, CAD, and daytime admission to the ICU are associated with early extubation.Copyright © 2020 Elsevier Inc. All rights reserved.

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