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KMID : 1189320230170020262
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Asian Spine Journal
2023 Volume.17 No. 2 p.262 ~ p.271
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Effect of Drain Duration and Output on Perioperative Outcomes and Readmissions after Lumbar Spine Surgery
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Brian Karamian
Parth Kothari
Gregory Toci
Mark James Lambrechts
Jose Canseco
Jennifer Mao
Raj Narayan
Samuel Alfonsi
Francis Sirch
Nadim Kheir
Nicholas Semenza
Barrett Woods
Jeffrey Rihn
Mark Kurd
Kris Radcliff
Ian David Kaye
Alan Hilibrand
Christopher Kepler
Alexander Richard Vaccaro
Gregory Schroeder
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Abstract
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Study Design: Single-center retrospective cohort.
Purpose: To compare surgical outcomes of patients based on lumbar drain variables relating to output and duration.
Overview of Literature: The use of drains following lumbar spine surgery, specifically with respect to hospital readmission, postoperative hematoma, postoperative anemia, and surgical site infections, has been controversial.
Methods: Patients aged ≥18 years who underwent lumbar fusion with a postoperative drain between 2017 and 2020 were included and grouped based on hospital readmission status, last 8-hour drain output (<40 mL cutoff), or drain duration (2 days cutoff). Total output of all drains, total output of the primary drain, drain duration in days, drain output per day, last 8-hour output, penultimate 8-hour output, and last 8-hour delta (last 8-hour output subtracted by penultimate 8-hour output) were collected. Continuous and categorical data were compared between groups. Multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis were performed to determine whether drain variables can predict hospital readmission, postoperative blood transfusions, and postoperative anemia. Alpha was 0.05.
Results: Our cohort consisted of 1,166 patients with 111 (9.5%) hospital readmissions. Results of regression analysis did not identify any of the drain variables as independent predictors of hospital readmission, postoperative blood transfusion, or postoperative anemia. ROC analysis demonstrated the drain variables to be poor predictors of hospital readmission, with the highest area under curve of 0.524 (drain duration), corresponding to a sensitivity of 61.3% and specificity of 49.9%.
Conclusions: Drain output or duration did not affect readmission rates following lumbar spine surgery.
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KEYWORD
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Surgical drain, Hematoma, Reoperation, Patient readmissions, Complications
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