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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

Authors :
Jad G. Khalil
Richard Easton
Mohamed Macki
Lonni Schultz
Sameah Haider
Ilyas S. Aleem
Muwaffak Abdulhak
Jason M. Schwalb
David R. Nerenz
Jacob Pawloski
Victor Chang
Seokchun Lim
Hassan Fadel
Paul Park
Michael Bazydlo
Hsueh-Han Yeh
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.

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