Rostin P, et al. - In this pre-specified, retrospective analysis of 71,025 patients who were previously independent adults undergoing non-cardiac surgery, researchers determined how long-term outcomes were influenced by desaturation in the operating theatre immediately after tracheal extubation. They focused on the link between desaturation events (oxygen saturation < 90%) within 10 minutes of tracheal extubation and adverse discharge (to a skilled nursing facility or long-term care facility). An adverse discharge was reported for 404 (12.3%) cases with and 5,035 (7.4%) cases without early postoperative desaturation. Higher odds of being discharged to a nursing facility were reported in relation to early postoperative desaturation. A higher risk of respiratory, renal, and cardiovascular complications as well as increased duration of hospital stay, postoperative intensive care unit admission frequency, and cost were observed in association with desaturation. High intra-operative long-acting opioid administration, high neostigmine dose, high intra-operative inspired oxygen concentration, and low oxygen delivery immediately before tracheal extubation were identified as modifiable factors that were related to desaturation. Including postoperative desaturation as an adverse outcome after tracheal extubation, anesthesiologists may consider developing guidelines to define tracheal extubation readiness.