[2026-01-26] Incidence and Factors Related to Reintubation After Planned Extubation in Patients Receiving General Anesthesia in Srinagarind Hospital

Krittiya Wanphon; Saranyoo Nonphiaraj; Siwalai Sucher; Kunrisa Bunworawatthana; Laksanawadee Chairatana; Thirada Jimrsa; Sasiwan Poorakorn

doi:10.33165/rmj.2026.e274955

Authors

Krittiya Wanphon Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 40002, Thailand https://orcid.org/0009-0007-6261-5878
Saranyoo Nonphiaraj Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0000-0002-8021-8792
Siwalai Sucher Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0000-0002-9275-3311
Kunrisa Bunworawatthana Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0009-0002-3261-697X
Laksanawadee Chairatana Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Thirada Jimrsa Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0000-0002-9343-3934
Sasiwan Poorakorn Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0009-0001-4968-7267

DOI:

https://doi.org/10.33165/rmj.2026.e274955

Keywords:

Incidence, Factors, Reintubation, RAP, General anesthesia, Planned extubation

Abstract

Background: Reintubation after planned extubation (RAP) is associated with adverse outcomes. Understanding the incidence and related factors can reduce complications and improve outcomes.

Objectives: To identify the incidence, related factors, causes, and outcomes of RAP in patients undergoing general anesthesia (GA).

Methods: This retrospective descriptive study was done at the Srinagarind Hospital. After screening incident reports from January 2022 to June 2024, an RAP, which is defined as an intubation conducted within 24 hours after surgery was identified. The primary outcome was the incidence of RAP. The secondary outcomes were the characteristics, causes, and outcomes. Logistic regression analysis was used to identify the factors related to poor long-term outcomes.

Results: The incidence of RAP was 8.59 per 10 000 GA (40/46 543 patients). The incidence per 10 000 GA was higher among male (12.08), the elderly (22.80), patients with an American Society of Anesthesiologists (ASA) classification of 4 (24.72), patients with respiratory disease (63.09), and individuals undergoing hepatobiliary surgery (26.90). Most RAP (50%) occurred in the postanesthesia care unit. The most common indications for RAP were hypoxemia (32.5%), altered consciousness (25%), and airway obstruction (20%). RAP was primarily attributed to patient factor (65%). Male gender was associated with an odds ratio of 0.11 for poor long-term outcomes (95% CI, 0.02-0.51; P = .005).

Conclusions: RAP occurred at a lower rate than previously reported. Incidence of RAP was high among males, the elderly, classified as ASA 4, preexisting respiratory diseases, and hepatobiliary surgery. The major cause of RAP was related to patient-related factors.

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