title: Analysis of risk factors for extubation failure in subjects submitted to non-emergency elective intracranial surgery.
abstract: BACKGROUND
  Extubation failure is defined as the re-institution of respiratory support ranging from 24 to 72 hours following scheduled extubation and occurs in 2% to 25% of extubated patients. The aim of this study was to determine clinical and surgical risk factors that may predict extubation failure in patients submitted to non-emergency intracranial surgery.
  
  
  METHODS
  This was a prospective observational cohort study. The study was carried out on 317 subjects submitted to non-emergency intracranial surgery for tumors, aneurysms, and arteriovenous malformation. Preoperative assessment was performed and subjects were followed up for the determination of extubation failure until either discharge from hospital or death.
  
  
  RESULTS
  Twenty-six (8.2%) of the 317 subjects experienced extubation failure following surgery. The following variables were considered for the multivariate analysis: level of consciousness at the time of extubation, duration of mechanical ventilation prior to extubation, sex and the use of intraoperative mannitol. The multivariate analysis determined that the most important variable for extubation failure was the level of consciousness at the time of extubation (P = .001), followed by female sex, which also showed to be significant (P = .006).
  
  
  CONCLUSIONS
  Lower level of consciousness (GCS 8T-10T) and female sex were considered risk factors for extubation failure in subjects submitted to elective intracranial surgery.
authors.affiliation: Department of Physiotherapy, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
authors.forename: Milena Carlos
authors.initials: MC
authors.lastname: Vidotto
authors.forename: Luciana Carrupt Machado
authors.initials: LC
authors.lastname: Sogame
authors.forename: Mariana Rodrigues
authors.initials: MR
authors.lastname: Gazzotti
authors.forename: Mirto Nelson
authors.initials: MN
authors.lastname: Prandini
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Jardim
mesh_terms: D000328:Adult; D060666:Airway Extubation; D001927:Brain Diseases / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D015300:Ventilator Weaning