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A Matched Cohort Analysis of Drain Usage in Elective Anterior Cervical Discectomy and Fusion
A Matched Cohort Analysis of Drain Usage in Elective Anterior Cervical Discectomy and Fusion
- Source :
- Spine. 47:220-226
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Study Design This is a retrospective, cohort analysis of multi-institutional database. Objective This study was designed to analyze the impact of drain use following elective anterior cervical discectomy and fusion (ACDF) surgeries. Summary of Background Data After ACDF, a drain is often placed to prevent postoperative hematoma. However, there has been no high quality evidence to support its use with ACDF despite the theoretical benefits and risks of drain placement. Methods The Michigan Spine Surgery Improvement Collaborative database was queried to identify all patients undergoing elective ACDF between February 2014 and October 2019. Cases were divided into two cohorts based on drain use. Propensity-score matching was utilized to adjust for inherent differences between the two cohorts. Measured outcomes included surgical site hematoma, length of stay, surgical site infection, dysphagia, home discharge, readmission within 30 days, and unplanned reoperation. Results We identified 7,943 patients during the study period. Propensity-score matching yielded 3,206 pairs. On univariate analysis of matched cohorts, there were no differences in rate of post-operative hematoma requiring either return to OR or readmission. We noted patients with drains had a higher rate of dysphagia (4.6% vs 6.3%; p = 0.003) and had longer hospital stay (p < 0.001). On multivariate analysis, drain use was associated with significantly increased length of stay (RR 1.23, 95% CI 1.13-1.34; p < 0.001). There were no significant differences in other outcomes measured. Conclusion Our analysis demonstrated that drain use is associated with significant longer hospital stay.
- Subjects :
- Michigan
medicine.medical_specialty
Univariate analysis
Multivariate analysis
business.industry
Postoperative hematoma
Anterior cervical discectomy and fusion
medicine.disease
Dysphagia
Surgery
Cohort Studies
Postoperative Complications
Spinal Fusion
Hematoma
Spine surgery
Cervical Vertebrae
medicine
Humans
Orthopedics and Sports Medicine
Neurology (clinical)
medicine.symptom
business
Diskectomy
Retrospective Studies
Cohort study
Subjects
Details
- ISSN :
- 15281159 and 03622436
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- Spine
- Accession number :
- edsair.doi.dedup.....e13b588bb06571b6acc00dba9b3ed5ae
- Full Text :
- https://doi.org/10.1097/brs.0000000000004169