日间颈前路椎间盘切除融合术患者延迟出院的危险因素研究OA

Objective To investigate the current status of delayed discharge in patients undergoing ambulatory anterior cervical discectomy and fusion(ACDF)and to analyze the risk factors.Methods A retrospective collection of clinical data was performed for patients underwent ambulatory ACDF at the First Affiliated Hospital of Zhejiang University School of Medicine from December 2021 to September 2024.Patients were divided into a normal discharge group(length of stay≤48 h)and a delayed discharge group(length of stay>48 h).Univariate analysis and multivariable logistic regression analy-sis were performed to identify the risk factors for delayed discharge.Results A total of 240 patients underwent ambulatory ACDF were enrolled in this study,including 32 patients with delayed discharge,yielding a delayed discharge rate of 13.33%.Univariate analysis showed that there were statistically significant differences between the two groups in age,sex,anesthesia recovery time,surgical segments,postoperative pain,anesthesia-related complications,and indwelling urinary catheterization(P<0.05).Multivariable logistic regression analysis showed that postoperative pain[OR=2.571,95%CI(1.479-4.470)],anesthesia-related complications[OR=5.308,95%CI(1.995-14.124)],and indwelling urinary cathe-terization[OR=4.914,95%CI(1.674-14.425)]were risk factors for postoperative delayed discharge in patients(P<0.05).Conclusion The severity of postoperative pain,the occurrence of anesthesia-related complications after surgery,and indwelling urinary catheterization are risk factors for delayed discharge in patients undergoing ambulatory ACDF.Clinical medical staff should pay close attention to high-risk populations,strengthen perioperative risk assessment and management,and formulate and implement systematic intervention protocols to reduce the incidence of delayed discharge.