Quality Improvement Program Increases Early Tracheal Extubation Rate and Decreases Pulmonary Complications and Resource Utilization After Cardiac Surgery

Background: Early tracheal extubation is a common goal after cardiac surgery and may improve postoperative outcomes. Our study evaluates the impact of a quality improvement program (QIP) on early extubation, pulmonary complications, and resource utilization after cardiac surgery. Methods: Between 2002 and 2006, 980 patients underwent early tracheal extubation ( 6 hours after surgery, conventional group). Outcomes compared between the two groups included: (1) pneumonia, (2) sepsis, (3) intensive care unit (ICU) length of stay, (4) hospital length of stay, (5) ICU readmission, and (6) reintubation. Logistic regression analysis and propensity score adjustment were used to adjust for imbalances in the patients’ preoperative characteristics. Results: Early extubation rates were significantly increased with QIP (QIP 53% vs. Non‐QIP 38%, p = 0.01). Early extubation was associated with a lower rate of (1) pneumonia (odds ratio [OR]= 0.35, 95% confidence intervals [CI]= 0.22–0.55, p