Nomogram for predicting fast-track in cardiac surgery in adult patients

Abstract

Abstract Background Early extubation is a critical procedure for fast-track and enhanced recovery after surgery (ERAS) in cardiac surgery for adult patients. It might improve patients postoperative recovery. Many factors have been suggested and anesthetic management have improved, but early extubation remains a major challenge. This study aims to create a nomogram for prediction of early-extubation for cardiac surgery in adult patients. Method We reviewed medical records of 442 consecutive patients undergoing elective cardiac surgeries from April 2023 to July 2023. Factors for early extubation were identified by multivariate logistic regression analysis and used to create a nomogram. The performance of the nomogram was evaluated by the area under the curve (AUC) and calibration plots. Result We created nomogram of extubation within 6 hours and 8 hours. Age, pulmonary hypertension, rocuronium, operative time, and ejection fraction were identified as significantly associated factors that could be combined for accurate prediction of extubation within 6 hours. Age, pulmonary hypertension, preoperative aspartate aminotransferase (AST), rocuronium, dexmedetomidine, operative time, transfusions, and preoperative N terminal pro B type natriuretic peptide (NT-proBNP) were identified as significantly associated factors that could be combined for accurate prediction of extubation within 8 hours. We created nomogram for early extubation by using these factors. The AUC of extubation within 6 hours was 0.795 and that of extubation within 8 hours was 0.734. Conclusion The nomogram could help for prediction of early extubation in elective cardiac surgery in adult patients.