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Appendix 1: Propensity Score Adjustment of Imbalances Between Groups.

Propensity Score Adjustment
Before Adjustment

After Adjustment

Gender (male)

0.008

0.966

Hypertension

0.004

0.971

Chronic Renal failure

<0.001

0.901

Previous Cerebrovascular Accident

<0.001

0.943

0.029

0.999

Previous CV Operation

<0.001

0.998

Congestive Heart Failure

<0.001

0.834

Unstable Angina

<0.001

0.985

Age >75 years

<0.001

0.870

Ejection Fraction <40

<0.001

0.992

NYHA Class

<0.001

0.999

Number of Diseased Vessels

<0.001

0.993

Case Priority

<0.001

0.915

Year of Surgery

<0.001

0.997

Type of Surgery

<0.001

0.739

STS Risk Score For Mortality

<0.001

0.908

p<0.05

COPD

Appendix 2: Multivariable Logistic Regression Analysis of Early Clinical Outcomes.
Pneumonia

Beta

SE

p

OR

CI

Early Extubation

-0.53

0.11

<0.001

0.35

0.23-0.52

Chronic Renal failure

0.43

0.14

0.001

2.37

1.40-4.03

Acute Myocardial Infarction

0.22

0.09

0.018

1.54

1.08-2.20

COPD

0.39

0.09

<0.001

2.18

1.52-3.13

Reoperation

0.18

0.08

0.023

1.44

1.05-1.98

Congestive Heart Failure

0.24

0.09

0.007

1.62

1.14-2.30

Age >75 years

0.28

0.10

0.003

1.77

1.21-2.58

Pump Time >125 min

0.29

0.08

<0.001

1.77

1.28-2.46

Sepsis

Beta

SE

p

OR

CI

Early Extubation

-0.43

0.15

0.004

0.43

0.24-0.77

Chronic Renal failure

0.51

0.16

0.001

2.80

1.50-5.23

Cerebrovascular Accident

0.30

0.14

0.027

1.83

1.07-3.11

Congestive Heart Failure

0.54

0.12

<0.001

2.96

1.87-4.68

Unstable Angina

0.26

0.13

0.036

1.69

1.04-2.77

Perfusion >125 min

0.43

0.11

<0.001

2.36

1.51-3.68

Prolonged LOS ICU ( >24 hrs)

Beta

SE

p

OR

CI

Early Extubation

-0.42

0.04

<0.001

0.43

0.36-0.51

Gender

-0.21

0.05

<0.001

0.66

0.54-0.80

Diabetes

0.11

0.05

0.014

1.25

1.05-1.49

Chronic Renal failure

0.76

0.15

<0.001

4.59

2.53-8.34

Cerebrovascular Accident

0.27

0.08

<0.001

1.70

1.27-2.28

COPD

0.16

0.06

0.012

1.36

1.07-1.73

Congestive Heart Failure

0.30

0.07

<0.001

1.82

1.40-2.37

Three Vessel Disease

-0.19

0.04

<0.001

0.69

0.58-0.82

Ejection Fraction < 40

0.15

0.05

0.005

1.35

1.10-1.68

Age >75 years

0.32

0.07

<0.001

1.88

1.44-2.46

Anesthesia Time > 293 min

0.16

0.05

0.002

1.38

1.13-1.69

Prolonged Hospital LOS

Beta

SE

p

OR

CI

Early Extubation

-0.50

0.06

<0.001

0.37

0.30-0.47

Gender

-0.24

0.05

<0.001

0.62

0.50-0.77

Diabetes

0.15

0.05

0.005

1.35

1.09-1.67

Chronic Renal failure

0.46

0.10

<0.001

2.51

1.70-3.72

Cerebrovascular Accident

0.17

0.07

0.021

1.40

1.05-1.87

COPD

0.24

0.07

<0.001

1.60

1.24-2.06

CABG

-0.24

0.07

<0.001

0.61

0.47-0.80

Congestive Heart Failure

0.33

0.06

<0.001

1.91

1.50-2.45

LVEF < 40

0.17

0.06

0.005

1.39

1.10-1.76

Age >75 Years

0.30

0.07

<0.001

1.83

1.41-2.37

Perfusion >125 min

0.32

0.06

<0.001

1.91

1.54-2.37

Readmission to the ICU

Beta

SE

p

OR

CI

Early Extubation

-0.35

0.08

<0.001

0.50

0.37-0.68

Chronic Renal failure

0.41

0.12

<0.001

2.26

1.41-3.63

Cerebrovascular Accident

0.24

0.09

0.012

1.60

1.12-2.32

COPD

0.23

0.09

0.007

1.59

1.13-2.22

Three Vessel Disease

-0.17

0.07

0.019

0.72

0.55-0.95

Reintubation

Beta

SE

p

OR

CI

Early Extubation

-0.37

0.10

<0.001

0.48

0.33-0.70

Hypertension

0.30

0.11

0.010

1.80

1.15-2.81

Congestive Heart Failure

0.31

0.09

<0.001

1.86

1.31-2.65

Cross Clamp >78 min

0.21

0.09

0.016

1.53

1.08-2.15

Cerebrovascular Accident

Beta

SE

p

OR

CI

Early Extubation

-0.79

0.20

<0.001

0.21

0.09-0.46

Hypertension

0.41

0.20

0.045

2.27

1.02-5.05

Cross Clamp >78 min

0.44

0.14

0.001

2.42

1.42-4.13

Renal Failure

Beta

SE

p

OR

CI

Early Extubation

-0.72

0.11

<0.001

0.24

0.15-0.37

Diabetes

0.26

0.08

0.001

1.67

1.22-2.27

Congestive Heart Failure

0.42

0.08

<0.001

2.31

1.67-3.19

Perfusion >125 min

0.34

0.08

<0.001

1.99

1.45-2.73

Reoperation for Bleeding

Beta

SE

p

OR

CI

Early Extubation

-1.02

0.14

<0.001

0.13

0.08-0.23

CABG

-0.42

0.10

<0.001

0.43

0.30-0.63

Anesthesia Time >293 min

0.23

0.09

0.009

1.58

1.12-2.23

Mortality

Beta

SE

P

OR

CI

Early Extubation

-0.39

0.14

0.004

0.46

0.27-0.78

Diabetes

0.30

0.11

0.006

1.82

1.19-2.77

Chronic Renal failure

0.37

0.16

0.020

2.11

1.12-3.98

CABG

-0.32

0.14

0.019

0.53

0.31-0.90

Reoperation

0.26

0.10

0.013

1.67

1.11-2.51

Congestive Heart Failure

0.47

0.11

<0.001

2.54

1.66-3.90

Unstable Angina

0.52

0.12

<0.001

2.80

1.78-4.42

Age >75 Years

0.43

0.12

<0.001

2.34

1.46-3.76

Pump Time >125 min

0.51

0.11

<0.001

2.78

1.84-4.20

COPD - Chronic Obstructive Pulmonary Disease;
CABG - Coronary Artery Bypass Grafting.

ICU - Intensive Care Unit; LOS - Length of Stay;

Appendix 3: Timing of Extubation and Postoperative Outcomes.
Mortality

Combined Morbidity

Mortality/Morbidity

C Statistic Sensitivity Specificity C Statistic Sensitivity Specificity C Statistic Sensitivity Specificity
<1 hr

0.53176

0.2%

93.5%

0.50367

0.9%

99.8%

0.50183

0.2%

99.4%

<2 hrs

0.53282

0.9%

92.5%

0.50582

1.9%

99.3%

0.50039

1.1%

98.8%

3 hrs

0.51800

5.8%

90.7%

0.52093

8.6%

95.6%

0.51525

7.8%

95.2%

<4 hrs

0.52479

16.2%

88.8%

0.56652

24.5%

88.9%

0.56124

23.8%

88.4%

<5 hrs

0.59135

31.4%

86.9%

0.60624

44.2%

77.1%

0.60177

43.7%

76.7%

<6 hrs

0.63392

43.6%

83.2%

0.62956

59.1%

66.9%

0.62636

58.8%

66.5%

<7 hrs

0.66578

50.9%

82.2%

0.65395

69.2%

61.6%

0.65155

69.0%

61.3%

<8 hrs

0.69155

57.0%

81.3%

0.68199

78.7%

57.7%

0.68030

78.6%

57.4%

<9 hrs

0.71542

62.7%

80.4%

0.69315

85.6%

53.0%

0.69125

85.5%

52.7%

<10 hrs

0.71317

66.9%

75.7%

0.69065

89.5%

48.6%

0.68835

89.4%

48.3%

<11 hrs

0.72019

70.2%

73.8%

0.68750

92.4%

45.2%

0.68549

92.3%

44.8%

<12 hrs

0.72911

73.9%

72.0%

0.68069

95.1%

41.1%

0.67899

95.0%

40.8%

< 13 hrs

0.72430

76.6%

68.2%

0.67675

97.4%

38.0%

0.67530

97.4%

37.7%

< 14 hrs

0.72390

78.4%

66.4%

0.66821

98.1%

35.6%

0.66688

98.1%

35.3%

< 15 hrs

0.73208

80.1%

66.4%

0.65982

98.6%

33.4%

0.65859

98.6%

33.1%

<16 hrs

0.73206

81.9%

64.5%

0.64991

99.2%

30.8%

0.64881

99.2%

30.6%

<17 hrs

0.71869

83.0%

60.8%

0.64230

99.4%

29.1%

0.64127

99.4%

28.9%

<18 hrs

0.72182

84.6%

59.8%

0.63261

99.7%

26.8%

0.63167

99.7%

26.6%

<19 hrs

0.72514

86.2%

58.9%

0.62105

99.8%

24.4%

0.62020

99.8%

24.2%

< 20 hrs

0.72264

87.5%

57.0%

0.61014

99.8%

22.2%

0.60936

99.8%

22.1%

<25 hrs

0.70896

91.3%

50.5%

0.58099

100.0%

16.2%

0.58043

100.0%

16.1%

<30 hrs

0.70456

92.3%

48.6%

0.57295

100.0%

14.6%

0.57245

100.0%

14.5%

REINTUBATION

LOS

ICU LOS

C Statistic Sensitivity Specificity C Statistic Sensitivity Specificity C Statistic Sensitivity Specificity
<1 hr

0.50200

0.5%

100.0%

0.50173

0.5%

99.8%

0.50402

0.9%

99.9%

<2 hrs

0.50622

1.2%

100.0%

0.50640

1.5%

99.8%

0.50562

1.9%

99.3%

<3 hrs

0.50158

5.9%

94.4%

0.52151

6.8%

97.5%

0.52169

8.5%

95.8%

<4 hrs

0.52549

16.3%

88.8%

0.56451

18.8%

94.1%

0.56369

23.7%

89.1%

<5 hrs

0.56379

31.4%

81.4%

0.60880

35.4%

86.4%

0.60079

42.8%

77.3%

<6 hrs

0.59741

43.7%

75.8%

0.63879

48.6%

79.2%

0.62385

57.5%

67.2%

<7 hrs

0.61510

51.0%

72.1%

0.65166

56.2%

74.1%

0.64887

67.6%

62.2%

<8 hrs

0.63648

57.1%

70.2%

0.66887

62.9%

70.9%

0.67592

76.8%

58.4%

<9 hrs

0.64601

62.7%

66.5%

0.67623

68.7%

66.6%

0.68917

83.9%

53.9%

<10 hrs

0.63885

66.9%

60.9%

0.67541

72.9%

62.2%

0.68546

87.7%

49.4%

<11 hrs

0.62624

70.0%

55.3%

0.67771

76.2%

59.3%

0.68410

90.8%

46.1%

<12 hrs

0.62548

73.5%

51.6%

0.68128

80.0%

56.3%

0.67742

93.5%

42.0%

<13 hrs

0.62394

76.3%

48.5%

0.68209

82.8%

53.6%

0.67479

96.0%

38.9%

<14 hrs

0.61366

78.0%

44.7%

0.67528

84.3%

50.8%

0.66763

97.0%

36.6%

<15 hrs

0.61871

79.6%

44.1%

0.67566

85.9%

49.2%

0.65998

97.6%

34.4%

<16 hrs

0.62202

81.6%

42.9%

0.67469

87.7%

47.2%

0.65068

98.3%

31.8%

<17 hrs

0.61173

82.6%

39.8%

0.67035

88.7%

45.4%

0.64330

98.6%

30.1%

<18 hrs

0.60999

84.1%

37.9%

0.66835

90.1%

43.5%

0.63443

99.1%

27.8%

<19 hrs

0.60515

85.6%

35.4%

0.66229

91.5%

41.0%

0.62296

99.3%

25.3%

<20 hrs

0.58943

86.8%

31.1%

0.65183

92.4%

38.0%

0.61300

99.4%

23.2%

<25 hrs

0.56402

90.4%

22.4%

0.63924

95.8%

32.1%

0.58448

99.9%

17.0%

<30 hrs

0.56615

91.5%

21.7%

0.63504

96.6%

30.4%

0.57602

99.9%

15.3%

*Where sensitivity is predicting patients who did not have the event out of those extubated early and specificity is predicting patients who had the event of those
NOT extubated early.
*Combined morbidity includes AMI, re-operation for bleeding, cerebrovascular accident, renal failure, sepsis, reintubation, hospital and ICU LOS.
*any infection includes deep sternal, thoracotomy, leg, septicemia, and UTI.
*mortality/morbidity includes mortality, AMI, re-operation for bleeding, cerebrovascular accident, renal failure, sepsis, reintubation, hospital and ICU LOS.
ICU = intensive care unit, UTI = urinary tract infection, AMI = acute myocardial infarction, LOS = length of stay