Factors Predictive of Increased Surgical Drain Output After Anterior Cervical Discectomy and Fusion

Basques, Bryce A.; Bohl, Daniel D.; Golinvaux, Nicholas S.; Yacob, Alem; Varthi, Arya G.; Grauer, Jonathan N.

doi:10.1097/brs.0000000000000237

Cited by 23 publications

(16 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 9 ] The primary outcome measure was increased drainage, and we defined this binary variable as positive when the drainage was greater than or equal to the 50th percentile of drainage for this cohort. [ 10 ]…”

Section: Methodsmentioning

confidence: 99%

Risk factors for increased postoperative drainage of calcaneal fractures after open reduction and internal fixation

et al. 2018

View full text Add to dashboard Cite

Sufficient drainage is very important for preventing wound complications after open reduction and internal fixation (ORIF) of calcaneal fractures. However, the drainage amount varies among patients. The objective of this study was to identify factors associated with increased postoperative drainage after ORIF of calcaneal fractures.A retrospective study including 87 patients with 92 calcaneal fractures in our hospital was performed. Patients were divided into 2 groups based on whether they had increased drainage, which was defined as a total drainage of ≥340 mL (50th percentile). We gathered the following data on each patient: age; sex; smoking history; body mass index (BMI); American Society of Anesthesiologists (ASA) classification; fracture type; the time from injury to surgery; operative time; bone grafting; preoperative labs including prothrombin time (PT), activated partial thromboplastin time (APTT), hematocrit, and D-dimer level; and histories for hypertension, diabetes, and heart disease. Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors associated with increased drainage.Total drainage ranged from 105 to 1185 mL, and the average drainage for this cohort was 393.6 ± 232.4 mL (mean ± standard deviation). 57.6% (n = 53) of patients had increased drainage. Smoking history, Sanders type, operative time, and bone grafting were significantly associated with increased drainage on univariate analysis. Multivariate logistic regression analysis then demonstrated that active smoking and higher Sanders type were independent risk factors for increased drainage.Patients with calcaneal fractures who smoked or had a higher level of Sanders type had a higher risk of increased postoperative drainage. Therefore, we suggest that active precautions be taken for these patients to reduce the rate of postoperative wound complications.

show abstract

Section: Methodsmentioning

confidence: 99%

Risk factors for increased postoperative drainage of calcaneal fractures after open reduction and internal fixation

et al. 2018

View full text Add to dashboard Cite

show abstract

“… 31 Along with that anemia was associated with an increased length of hospital stay, an important marker of hospital costs and predictor of adverse outcomes in high-risk spinal surgery. 32 , 33 Given that in most cases minimal blood loss and transfusions are required for ACDF surgery, 34 , 35 the association between anemia with complications in this study suggests that anemia may be a proxy variable that indicates patients’ general poor health, rather than having a direct bearing on surgery itself. Anemia is multifactorial and more so related to patient comorbidities, which include some confounders that could not be accounted for in the present multivariable analysis.…”

Section: Discussionmentioning

confidence: 85%

Effect of Preoperative Anemia on the Outcomes of Anterior Cervical Discectomy and Fusion

Phan

Wang

Kim

et al. 2017

Global Spine Journal

View full text Add to dashboard Cite

Study Design:Retrospective cohort study.Objective:Preoperative anemia has been associated with an increased need for blood transfusions and postoperative complications. The effects of anemia on the outcomes of anterior cervical discectomy and fusion (ACDF) have not been explored. The present study aimed to evaluate the association between preoperative anemia and 30-day complications following ACDF surgery.Methods:Data from the American College of Surgeons National Surgical Quality Improvement Program (2005-2012) was used. Preoperative anemia was defined as hematocrit <39% for males and <36% for females. A bivariate analysis was performed on demographic and perioperative variables. Multivariable logistic regression models were employed, adjusting for patient variables, to identify independent risk factors for complications.Results:A total of 3500 patients were included of which 444 (12.7%) were anemic patients. Multivariate analysis was used to quantify the predictive power of anemia on key postoperative outcomes, while controlling for the other statistically significant. Preoperative anemia was found to be a statistically significant predictor of any complication (odds ratio [OR] = 1.853; 95% confidence interval [CI] = 1.17-2.934; P = .0086), pulmonary complications (OR = 3.269; 95% CI = 1.745-6.126; P = .0002), intraoperative blood transfusion (OR = 4.364; 95% CI = 1.48-12.866; P = 0.0076), return to operating theatre (OR = 2.655; 95% CI = 1.539-4.582; P = .0005), and length of hospital stay more than 5 days (OR = 2.151; 95% CI = 1.499-3.085; P < .0001).Conclusion:Preoperative anemia appears to be a significant predictor of perioperative complications, reoperation, and extended length of hospital stay in patients undergoing elective ACDF. Future studies should explore outcomes of treatment of preoperative anemia prior to surgery to determine the optimal management strategy.

show abstract

“…A thorough understanding of the development of increased surgical drain output in cervical degenerative population treated with ACCF is a critical component to assist surgeons with the decision of whether or not to place a drain postoperatively. Although previous reports have challenged the efficacy of drains for many surgical procedures, little has assessed the necessity of drain use after ACCF [ 15 – 18 ]. This study compared the patients who underwent ACCF with increased surgical drain output and those who did not.…”

Section: Discussionmentioning

confidence: 99%

“…It has been previously suggested that age was associated with an increased prevalence of increased drain output following spine surgery. Basques et al found that patients with age 50 years or more were more likely to have increased drain output following ACDF and deduced that this effect may be due to delayed wound healing associated with increased age [ 18 ]. Similarly, Sokolowski et al found that advanced age is an independent risk factor associated with postoperative hematoma volume.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for predicting increased surgical drain output in patients after anterior cervical corpectomy and fusion

Liang

Chen

et al. 2017

J Orthop Surg Res

View full text Add to dashboard Cite

BackgroundAlthough measures to reduce and treat the postoperative surgical drain output are discussed, along with the increased interest in causative factors related to the prevention and treatment reported by many studies, these are still controversial.MethodsA retrospective study was conducted on a consecutive series of 217 patients who had underwent ACCF between January 2016 and March 2017. Patients were categorized based on normal or increased total drain output. These two groups were compared for demographic distribution and clinical data to investigate the predictive factors of increased drain output by multivariate analysis.ResultsThe overall incidence rate of increased drain output after ACCF was 16.6%. There are no significant differences in sex, BMI, history of taking aspirin, and ASA classification between the two groups (P > 0.05). Of the patients with increased drain output, a significantly higher proportion of patients have OPLL in the surgical level, 18 (50.0%) versus 33 (18.2%) (P = 0.000). The mean age was 60.67 ± 8.18 years versus 54.41 ± 10.05 years (P = 0.001). Number of discs involved was 2.42 ± 0.50 versus 2.02 ± 0.65 (P = 0.001). Operation time was 112.22 ± 16.49 min versus 105.21 ± 17.89 min (P = 0.031). Intraoperative blood loss was 109.86 ± 62.02 mL versus 87.83 ± 56.40 mL (P = 0.036). Logistic regression analysis showed that age (OR, 1.075; p = 0.003), history of smoking (OR, 2.792; p = 0.021), OPLL in surgical level (OR, 2.107; p = 0.001), and number of discs involved (OR, 2.764; p = 0.003) maintained its significance in predicting likelihood of increased surgical drain output.ConclusionsThe occurrence of increased drain output after ACCF is most likely multifactorial and is related to age, history of smoking, OPLL in surgical level, and number of discs involved.

show abstract

Factors Predictive of Increased Surgical Drain Output After Anterior Cervical Discectomy and Fusion

Cited by 23 publications

References 31 publications

Risk factors for increased postoperative drainage of calcaneal fractures after open reduction and internal fixation

Risk factors for increased postoperative drainage of calcaneal fractures after open reduction and internal fixation

Effect of Preoperative Anemia on the Outcomes of Anterior Cervical Discectomy and Fusion

Risk factors for predicting increased surgical drain output in patients after anterior cervical corpectomy and fusion

Contact Info

Product

Resources

About