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Clinical Factors Affecting Length of Stay After 100 Consecutive Cases of Primary Cleft Lip Repair
Insights
This study analyzed 100 infants undergoing primary cleft lip repair (PCLR), finding longer anesthesia duration increased hospital stay. Increased oral intake and acetaminophen use decreased length of stay (LOS).
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Healthcare Management
Background:
- Primary cleft lip repair (PCLR) is a common surgical procedure in infants.
- Understanding factors influencing hospital length of stay (LOS) is crucial for optimizing patient care and resource allocation.
- Current protocols for post-PCLR observation vary, necessitating analysis of actual hospital course.
Purpose of the Study:
- To analyze the hospital course of 100 infants following primary cleft lip repair (PCLR).
- To identify perioperative factors associated with length of stay (LOS) after PCLR.
- To evaluate the appropriateness of routine outpatient or short-stay observation protocols.
Main Methods:
- Retrospective analysis of 100 consecutive infants undergoing PCLR at a tertiary care center.
- Collection and analysis of demographic and perioperative data, including duration of surgery and anesthesia.
- Multivariate linear regression models were used to identify factors correlating with LOS.
Main Results:
- Mean LOS was 35.8 ± 13.9 hours. No demographic factors correlated with LOS.
- Longer duration of general anesthesia was significantly associated with increased LOS (P = .002).
- Greater postoperative oral intake (P = .000) and higher acetaminophen dosage (P = .000) correlated with decreased LOS.
Conclusions:
- Perioperative factors, particularly anesthesia duration, significantly influence LOS after PCLR.
- Increased oral intake and appropriate analgesia (acetaminophen) are associated with shorter hospital stays.
- Findings challenge the routine use of outpatient or short-stay observation for all infants post-PCLR.
Objective:
To analyze the hospital course of 100 consecutive infants after primary cleft lip repair (PCLR) and identify factors related to length of stay (LOS).
Design:
Retrospective analysis of 100 consecutive infants who were routinely admitted after PCLR.
Setting:
Tertiary care center.
Patients:
One hundred consecutive infants undergoing PCLR. Demographic and perioperative data were collected and analyzed.
Main Outcome Measure:
LOS, planned before data collection.
Results:
Male:female ratio was 65:35. Seventy-two infants had unilateral cleft lip; syndromic association was documented in 15 patients. Mean age and weight at PCLR were 5.6 ± 4.0 months and 6.7 ± 1.3 kg, respectively. Mean duration of surgery was 2.5 ± 0.9 hours, and mean duration of general anesthesia was 3.4 ± 0.9 hours. A total of 3.3 ± 1.5 mL of intraoperative local anesthetic was used per patient. Intravenous fluids were necessary after transfer from the post-anesthesia care unit to the general ward in 98% of patients. Almost half (44%) of all patients received intravenous morphine 23 hours or more after hospital admission. Mean LOS was 35.8 ± 13.9 hours. No association was identified between patient demographic factors and LOS. Multivariate linear regression models identified significant positive correlation between LOS and duration of general anesthesia (P = .002). Greater volume of postoperative oral intake (P = .000) and higher acetaminophen dosage on the floor (P = .000) correlated with decreased LOS.
Conclusions:
This study identifies perioperative factors associated with LOS. Our findings question the safety of routine outpatient or short-stay observation after PCLR.
