Prolonged drain usage after lumbar decompression, fusion may lead to longer length of stay
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Drains left in for longer periods or until there was less output after lumbar decompression and/or fusion did not significantly impact postoperative outcomes but led to longer lengths of hospital stay, according to results presented here.
Parth Kothari, MD, and colleagues retrospectively reviewed 1,167 patients undergoing lumbar decompression and/or fusion who had a drain placed.
“A common [criterion] at our institution is 40 ccs of output per an 8-hour shift as a [criterion] for removing the patient’s drain, and so we looked at the data with greater than 40 ccs output over a shift vs. less than that,” Kothari said in his presentation at the North American Spine Society Annual Meeting. “Other surgeons use a cutoff of 48 hours postoperatively, and so we looked at drains removed earlier than that vs. later than that and then we compared the data and postoperative outcomes.”
Patients in the greater drain output group had an average output of 65 ccs per shift vs. 14 ccs per shift in the lower output group, according to Kothari. He noted patients who had greater drain output had a shorter length of duration that the drain was in, as well as a statistically shorter length of hospital stay.
“But the patients whose drains were putting out so more did not have a higher rate of readmission, reoperation, surgical site infection or transfusion,” Kothari said.
Kothari noted patients who had their drains in for longer than 2 days postoperatively had a higher length of stay and lower drain outputs on removal. Patients who had their drains in for longer than 2 days postoperatively did not have lower readmissions, reoperations or rate of surgical site infection, he added.
“When we looked at the multivariate analysis seeing if these were independent risk factors for readmission – based on the univariate analysis, we didn’t expect they would be –and they were not significant,” Kothari said.
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Kothari P, et al. Paper 135. Presented at: North American Spine Society Annual Meeting. Sept. 29 - Oct. 2, 2021; Boston (hybrid meeting).
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