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

Abstract

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.

Pedicle screw placement in spinal neurosurgery using a 3D-printed drill guide template: a systematic review and meta-analysis

“…The confidence interval of the weighted mean difference (WMD) was wide and the possibility that the real WMD favors largely the group of drill guide template. We think that there are two factors contributing to the above results: the limited number of studies that we included and less intraoperative blood loss in the cervical surgery [33,34]. This study illustrated the advantages of the drill guide template, which can accurately and effectively increase the accuracy rate of pedicle screw placement and decrease the risk of postoperative complications, such as shorten the operative time and reduce intraoperative blood loss.…”

Predictors of Increased Surgical Drain Output following Type I Thyroplasty for Glottic Insufficiency

“…Although no other studies have reported risk factors for increased drain output following type I thyroplasty, our findings corroborate evidence from several other surgical procedures. In two separate studies on patients undergoing anterior cervical discectomy, history of smoking and older age were both found to predict higher surgical drain output postoperatively 11,12 . History of smoking has been associated with an increased risk of bleeding following other head and neck surgeries, including thyroidectomies 13 and tonsillectomies 14 .…”

Drains in Spine Surgery for Degenerative Disc Diseases: A Literature Review to Determine Its Usage

“…The most common reason spine surgeons place a drain following anterior cervical surgery is the prevention of wound hematoma due to the feared consequence of airway compromise [4,20,21]. This complication occurs in roughly 0.20% of patients undergoing anterior cervical surgery [22,23].…”

“…If not recognized expeditiously, airway compromise can progress quickly increasing morbidity and mortality. Thus, some surgeons believe it is important to know which factors are associated with increased drain output to guide patient selection on drain placement [20,21].…”