title: Factors influencing delayed extubation after infratentorial craniotomy for tumour resection: a prospective cohort study of 800 patients in a Chinese neurosurgical centre.
abstract: OBJECTIVE
  To investigate prospectively the rate of, and factors influencing, delayed extubation following infratentorial craniotomy in a Chinese neurosurgical centre.
  
  
  METHODS
  Patients undergoing infratentorial craniotomy for tumour resection were prospectively enrolled and stratified according to whether extubation was attempted in the operating theatre (early extubation) or not (delayed extubation). Pre- and intraoperative variables were collected and analysed. Multiple logistic regression analysis was performed, to identify factors related to delayed extubation.
  
  
  RESULTS
  The study included 800 patients, 398 (49.8%) of whom underwent delayed extubation. The overall rate of extubation failure was 3.6%. Independent factors related to delayed extubation were: preoperative lower cranial nerve dysfunction; hydrocephalus; tumour location; duration of surgery ≥ 6 h; estimated blood loss ≥ 1000 ml. Compared with patients in the early extubation group, those in the delayed extubation group had a higher rate of pneumonia, longer intensive care unit and postoperative hospital stays, and higher hospitalization costs.
  
  
  CONCLUSIONS
  Brain stem and lower cranial nerve function were the main factors affecting extubation decision-making. Further research is required, to establish criteria for delayed extubation following infratentorial craniotomy.
authors.affiliation: Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ye-Hua
authors.initials: YH
authors.lastname: Cai
authors.forename: Heng-Yu
authors.initials: HY
authors.lastname: Zeng
authors.forename: Zhong-Hua
authors.initials: ZH
authors.lastname: Shi
authors.forename: Jing
authors.initials: J
authors.lastname: Shen
authors.forename: Yan-Ni
authors.initials: YN
authors.lastname: Lei
authors.forename: Bi-Yao
authors.initials: BY
authors.lastname: Chen
authors.forename: Jian-Xin
authors.initials: JX
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation; D002681:China; D003399:Craniotomy; D005260:Female; D006801:Humans; D015192:Infratentorial Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D011182:Postoperative Care; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome