The Association Between Extubation Time and Perioperative Outcomes in Valve Surgery Patients: A Retrospective Study

Abstract Background For patients undergoing valve repair, how soon the tracheal tube is removed may shape postoperative recovery. Late extubation has been tied to heavier vasoactive support and longer intensive care. We examined whether extubation timing tracked with perioperative outcomes in 127 patients who had valve repair surgery. Methods This single-center retrospective review covered patients treated between March 2023 and May 2025, divided by extubation timing into early (≤ 6 h) and late (> 6 h) groups. Vasoactive support was quantified as the vasoactive-inotropic score indexed to ICU hours (VISmean). Group differences were tested with the Mann–Whitney U test or Fisher’s exact test, and multivariable linear regression on log-transformed outcomes adjusted for age, sex, heart failure, mitral regurgitation, and NYHA class. Results After adjustment, late extubation was associated with a higher VISmean (geometric mean ratio + 35.3%, 95% CI + 13.4% to + 61.5%, P = 0.0009), longer ICU stay (+ 28.6%, + 6.0% to + 56.2%, P = 0.011), and longer operation time (+ 8.7%, + 2.1% to + 15.8%, P = 0.010). No interaction with valve pathology reached significance. Conclusions Late extubation in valve repair patients is associated with heavier vasoactive support and longer ICU stay. These associations may reflect underlying disease severity more than the timing of extubation itself.