Key result
Age ≥ 75 years (OR 5.149), female sex (OR 5.185), and Clavien-Dindo grade > 1 (OR 15.936) were independently associated with prolonged length of stay despite an ERAS protocol.
Why the study?
The study was conducted to identify risk factors associated with prolonged length of stay despite an enhanced recovery after surgery protocol in short-level lumbar fusion surgery.
What are the independent risk factors for prolonged length of stay in elderly patients undergoing short-level lumbar fusion surgery despite an ERAS protocol?
Cohort (n=186)
No
What are the independent risk factors for prolonged length of stay in elderly patients undergoing short-level lumbar fusion surgery despite an ERAS protocol?
Odds Ratio: 5.149 (95% CI 2.045–12.966)
p-value: p=0.001
In elderly patients undergoing short-level lumbar fusion surgery with an ERAS protocol, age ≥75 years, female sex, and postoperative complications (Clavien-Dindo >1) are independent risk factors for prolonged hospital stay.
May guide targeted support for high-risk ERAS patients; leaves open whether protocol refinements reduce prolonged stays.
Objective To identify the risk factors associated with prolonged length of stay (LOS) despite an enhanced recovery after surgery (ERAS) protocol in short-level lumbar fusion surgery. Methods ERAS was implemented maturely at our department in January 2019. We gathered data for all patients undergoing short-level lumbar fusion surgery from May to November 2021. Given the discharge criterias, a threshold was set according to mean LOS, and two groups were spontaneously formed: LOS shorter than the threshold for discharge (Group 1, n = 114) and LOS longer or equal to the threshold for discharge (Group 2, n = 72). Preoperative metrics were compared to identify risk factors associated with prolonged LOS. Results A total consecutive 186 patients with complete medical records were enrolled (77 males and 109 females; mean age 71.08 ± 5.70 years). After dichotomization according to the threshold for discharge, there were 114 patients in Group 1 and 72 in Group 2. Statistical analysis demonstrated that age ≥ 75 years (p = 0.002), female sex (p < 0.001), American Society of Anesthesiologists grade ≥ 3 (p = 0.035), operation time (p < 0.001), anesthesia time (p < 0.001, ambulation time > 1 day (p = 0.027), removal of urinary catheter time > 1 day (p = 0.019), fusion levels (p < 0.001), Clavien-Dindo grade > 1 (p < 0.001) and allogenetic transfusion (p = 0.009) were significantly related to prolonged LOS. Binary logistic regression revealed that age (odds ratio (OR) 5.149; 95% confidence interval (CI) 2.045–12.966, p = 0.001), sex (OR 5.185, 95% CI 2.183–12.317, p < 0.001) and Clavien-Dindo grade > 1(OR 15.936, 95% CI 5.220–48.652, p < 0.001) were independent risk factors of prolonged LOS. Conclusions In this retrospective study, we analysed the potential risk factors associated with delayed LOS despite implementing ERAS, further, binary logistic regression exhibited that age ≥ 75 years old, female sex and Clavien-Dindo grade > 1 were independently correlated with prolonged LOS.
No takes yet. Share an insight, caveat, or question.
Cui et al. (2022) conducted a cohort in Lumbar disk herniation, lumbar spinal stenosis, and lumbar spondylolisthesis (n=186). Age ≥ 75 years vs. Age < 75 years was evaluated on Prolonged length of stay (LOS ≥ threshold for discharge) (OR 5.149, 95% CI 2.045-12.966, p=0.001). Age ≥ 75 years (OR 5.149), female sex (OR 5.185), and Clavien-Dindo grade > 1 (OR 15.936) were independently associated with prolonged length of stay despite an ERAS protocol.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: