In-Hospital Outcomes of Early Extubation in Post CABG Patients: A Retrospective Study from a Tertiary Care Hospital in Karachi, Pakistan

Abstract: Background: The Society of Thoracic Surgeons established extubation within six hours of surgery as a standard quality of care supported by clear national registry information on positive effects. This is evident that clinical profile of patients undergoing coronary artery bypass grafting (CABG) is changing over the time and there is paucity of such data from Pakistan. Objective: To determine in-hospital outcomes of early extubation among CABG patients in a tertiary care hospital. Materials and Methods: This retrospective chart review was performed by Cardiac Surgery Department at Liaquat National Hospital during March to August, 2025. Data was retrospectively retrieved and reviewed for year 2023 and 2024. Early extubation was defined as extubation within six hours of surgery. Data was retrieved for patients’ demographics, clinical features and in-hospital outcomes from patients’ medical record files. Result: A total of 206 records were reviewed. Mean age of patients was 58.8 ± 8.5 years. Early extubation was seen in 36.4% patients. Intubation time (hours) (5.3 ± 0.3 versus 9.8 ± 3.7, p<0.001), ICU stay (days) (26.8 ± 1.8 versus 35.7 ± 6.9, p<0.001) and overall hospital stay (days) (6.5 ± 0.5 versus 7.4 ± 0.5, p<0.001) were significantly lower among patients who underwent early extubation. Reintubation rate (1.3% versus 3.8%, p=0.420), respiratory complication rate (2.7% versus 8.4%, p=0.140) and death rate (2.3% versus 5.3%, p=0.260) were not significantly different among early and late extubated patients. Conclusion: The findings of the present study support that the practice of early extubation was safe and beneficial in post CABG patients with lower ICU days and overall hospital stay in contrast to the patients with prolonged intubation. Keywords: Cardiac surgery, Coronary artery bypass grafting, Fast-track cardiac care, Intubation, Extubation, Anesthesia.