Risk factors and a predictive model for delayed extubation in children undergoing primary repair of tetralogy of Fallot: a retrospective cohort study with rigorous methodological validation.

This internally validated model integrates preoperative anatomical (McGoon ratio, RVOT diameter), intraoperative (CPB time), and postoperative physiological (inotropic score, oxygenation, PVOV) factors.

It may serve as a potentially useful tool for early risk stratification and could support a dual-phase assessment strategy to guide targeted interventions in pediatric Tetralogy of Fallot repair.

External validation in independent cohorts and prospective clinical implementation studies are warranted before routine clinical adoption.