Objective To investigate the risk factors of extubation in non-operating room after adult liver transplantation. Methods A total of 438 adult patients underwent liver transplantation with general anesthesia from 2016 to 2019 were included, involving 339 males and 99 females, aged 18-78 years, BMI 13-37 kg/m2, and ASA physical status Ⅱ-Ⅴ. According to the site where tracheal extubation occurred after surgery, patients were divided into two groups: operating room extubation group and non-operating room extubation group. Datas including characteristics, information of preoperative disease, preoperative laboratory variables, and intraoperative variables were collected. Multivariate Logistic regression model was used to analyze the risk factors of extubation in non-operating room. Results There were 326 (74.4%) patients in the non-operating room extubation group. Compared to the operating room extubation group, the percentage of male, the proportion of ASA physical status Ⅱ, preoperative hemoglobin level, and albumin level were significantly decreased, the model for end-stage liver disease (MELD) score, international normalized ratio, and total bilirubin value were significanthy increased, prothrombin time, activated partial thromboplastin time, and the duration time of surgery were significantly prolonged, the dose of sufentanil, fluid infusion,the dose of red blood cells transfusion and the maximum dose of epinephrine or norepinephrine were significantly increased in the non-operating room extubation group (P < 0.05). Multivariate Logistic analysis showed that preoperative smoking (OR = 1.67, 95% CI 1.01-2.78, P < 0.05), increased surgery time (OR = 1.30, 95% CI 1.10-1.52, P < 0.05), increased red blood cell transfusion (OR = 1.12, 95% CI 1.08-1.19, P < 0.05), and increased maximum doses of epinephrine or norepinephrine (OR = 1.32, 95% CI 1.00-1.61, P < 0.05) were independent risk factors of extubation in the non-operating room. Conclusion Preoperative smoking, increased surgery time, increased red blood cell transfusion and increased maximum dose of epinephrine or norepinephrine are independent risk factors of extubation in non-operating room after adult live transplantation. |