Risk factors for predicting increased surgical drain output in patients after anterior cervical corpectomy and fusion

Although measures to reduce and treat the postoperative surgical drain output are discussed, along with the increased interest in causative factors related to the prevention and treatment reported by many studies, these are still controversial.

A retrospective study was conducted on a consecutive series of 217 patients who had underwent ACCF between January 2016 and March 2017. Patients were categorized based on normal or increased total drain output. These two groups were compared for demographic distribution and clinical data to investigate the predictive factors of increased drain output by multivariate analysis.

The overall incidence rate of increased drain output after ACCF was 16.6%. There are no significant differences in sex, BMI, history of taking aspirin, and ASA classification between the two groups (P > 0.05). Of the patients with increased drain output, a significantly higher proportion of patients have OPLL in the surgical level, 18 (50.0%) versus 33 (18.2%) (P = 0.000). The mean age was 60.67 ± 8.18 years versus 54.41 ± 10.05 years (P = 0.001). Number of discs involved was 2.42 ± 0.50 versus 2.02 ± 0.65 (P = 0.001). Operation time was 112.22 ± 16.49 min versus 105.21 ± 17.89 min (P = 0.031). Intraoperative blood loss was 109.86 ± 62.02 mL versus 87.83 ± 56.40 mL (P = 0.036). Logistic regression analysis showed that age (OR, 1.075; p = 0.003), history of smoking (OR, 2.792; p = 0.021), OPLL in surgical level (OR, 2.107; p = 0.001), and number of discs involved (OR, 2.764; p = 0.003) maintained its significance in predicting likelihood of increased surgical drain output.

The occurrence of increased drain output after ACCF is most likely multifactorial and is related to age, history of smoking, OPLL in surgical level, and number of discs involved.