Researchers at Columbia University in New York City combed through more than 230,000 patient records to determine unplanned post-op intubation. The risk factors identified were age, ASA physical status, preoperative sepsis, and total operative time. Editorial review of the study pointed out the decision of when to extubate a high-risk patient was complex taking into account the knowledge, training, and experience of the anesthesia provider. The review also cautioned against overemphasis on reducing unplanned intubations as it could result in unnecessarily prolonged intubation and over reluctance to reintubate.