Risk Factors for Increased Surgical Drain Output in Patients After Unilateral Expansive Open-Door Cervical...

This study aimed to investigate determinants independently correlated with increased surgical drain output (ISDO) observed following unilateral expansive open-door cervical laminoplasty (UEOCL) procedures performed in individuals diagnosed with cervical spondylotic myelopathy.

This retrospective cohort study analyzed medical records from a single tertiary care center spanning January 2013 to December 2019 to identify individuals undergoing UEOCL with prophylactic drainage. Cases were stratified into 2 cohorts based on cumulative drainage volume, with the experimental group defined by outputs ≥500 ml (ISDO classification). Demographic characteristics, intraoperative parameters, and postoperative variables were systematically evaluated through univariate and multivariate statistical approaches to establish potential predictors of excessive fluid secretion.

Among the 341 eligible UEOCL cases identified through inclusion criteria screening, the mean postoperative drainage volume across the cohort measured 449.0 ± 167.1 ml. Of these, 131 subjects (38.4%) exhibited ISDO criteria, defined as drainage exceeding 500 ml. Multivariable regression analysis identified 4 independent predictors: male gender (P = 0.011), age under 60 years (P = 0.008), elevated preoperative diastolic blood pressure (P = 0.039), and application of lateral mass screw fixation (P = 0.001). Those meeting ISDO criteria demonstrated extended hospitalization durations (P = 0.047) and increased medical expenditures (P < 0.001) compared to counterparts with typical drainage volumes.

Multivariate analysis identified male gender, younger age (below 60 years), elevated preoperative diastolic blood pressure, and lateral mass screw fixation as independent predictors of ISDO development post-UEOCL. Furthermore, the presence of ISDO demonstrated significant correlations with prolonged hospitalization duration and elevated inpatient financial expenditures.