Risk Factors for Predicting Increased Surgical Drain Output in Patients After Anterior Cervical Decompression and Fusion.

OBJECTIVE

Tje objective of this study was to identify factors that are independently associated with increased surgical drain output (ISDO) in patients who have undergone anterior cervical decompression (discectomy/corpectomy) and fusion (anterior cervical discectomy and fusion [ACDF]/anterior cervical corpectomy and fusion [ACCF]).

METHODS

Consecutive patients who underwent ACDF/ACCF with surgical drain placement at a single academic institution between January 2013 and December 2017 were identified from the medical records. Patients were categorized into normal or ISDO groups, with ISDO defined as a total drain output of 100 ml or more. The demographic distribution and clinical data of these 2 groups were incorporated into univariate and multivariate analyses to investigate the predictive factors of ISDO.

RESULTS

A total of 791 patients with ACDF/ACCF met the inclusion criteria. The average drain output for this cohort was 104.9 ± 55.9 ml. Among all patients in the study, 378 patients had ISDO (drain output >100 ml). Our analysis identified the following independent predictors of ISDO in all patients: male sex (P < 0.001), age 50 years or older (P = 0.018), the number of discs involved (P < 0.001), and C3 involvement (P = 0.002). Among the patients undergoing ACDF, male sex (P < 0.001), the number of discs involved (P < 0.001), and C3 involvement (P = 0.004) were significant predictors of ISDO. Among those undergoing ACCF, male sex (P < 0.001) and the number of discs involved (P < 0.001) were significant predictors of ISDO.

CONCLUSIONS

Male sex, age 50 years or older, the number of discs involved, and C3 involvement were significant risk factors for ISDO following anterior cervical decompression and fusion. Patients with these risk factors may benefit from surgical drain placement.