Factors Associated with Operating-Room Extubation after Emergency Craniotomy
Ananchanok Saringcarinkul MD*, Suchanya Suwannachit MD*, Yodying Punjasawadwong MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand
Objective : To determine clinical factors and outcomes associated with operating-room extubation.
Material and Method: Three hundred seventy three medical records of emergency craniotomy were reviewed. The author
categorized by whether the patients underwent operating-room extubation (ORE) or not (nORE). Demographic and
perioperative factors were reviewed for association with ORE, e.g. Glasgow coma scale score (GCS), brain edema, and
duration of anesthesia. Outcomes included clinical status, and duration in intensive care unit and hospital stay.
Results : Of the 373 patients, 130 (35%) had been extubated in the operating room. The strongest factors associated with
ORE were no perioperative brain edema (adjusted odds ratio [OR] = 76.44 [95% confidence interval 9.46-617.50], p<0.001),
high GCS score from 13 to 15 (adjusted OR = 3.74 [1.99-7.01], p<0.001), and better ASA physical class IE or IIE (adjusted
OR = 2.09 [1.21-3.59], p = 0.008). The median lengths of time in the intensive care unit (ICU) were significantly shorter
among OREs (3 days, range 2-5) than nOREs (4 days, range 3-8), p<0.001, as well as for duration of hospital stay (7 days,
range 4-10 vs. 8 days, range 5-13, respectively, p = 0.008).
Conclusion : After emergency neurosurgery, ORE is associated with absent cerebral edema, high GCS score, and better
ASA status.
Keywords : Operating room, Extubation, Emergency craniotomy
