Objective  This study aimed to identify the risk factors for unplanned reintubation after head and neck surgery.

  Methods  This study retrospectively investigated cases that received head and neck surgery in Peking Union Medical College Hospital from January 1, 2014 to December 31, 2018. Patients who received unplanned reintubation after head and neck surgery were enrolled in the study group. Patients who extubated successfully were randomly sampled for the control group. The proportion of patients in the study group and the control group was 1:4. Multivariable Logistic regression analysis was used to assess the risk factors for unplanned reintubation after head and neck surgery.

  Results  A total of 60 eligible cases (12 cases of the study group, 48 cases of the control group) meeting the inclusive and exclusive criteria were included in this study. Multivariable Logistic regression analysis revealed that general anesthesia history (OR=9.17, 95% CI: 1.05-83.33, P=0.045), Cormack-Lehane grading Ⅲ (OR=18.87, 95% CI: 1.53-250.00, P=0.022), and intraoperative fluid load ≥20 mL/kg (OR=27.78, 95% CI: 1.94-500.00, P=0.014) were risk factors for unplanned reintubation after head and neck surgery. Compared with the control group, postoperative hospital stay time7(3.0, 17.0)d vs. 2(2.0, 5.0)d, P=0.013 and ICU stay time1(0.0, 2.8)d vs. 0(0.0, 0.0)d, P < 0.001 of the study group were prolonged significantly.

  Conclusions  Unplanned reintubation after head and neck surgery is associated with general anesthesia history, Cormack-Lehane grading, and intraoperative fluid load. It acts as a negative factor for patients' rehabilitation.