The Potential Risk Factors for Prolonged Length of Stay Despite an Enhanced Recovery After Surgery Protocol for Elderly Patients Undergoing Short-Level Lumbar Fusion Surgery

Abstract

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 We gathered data for all patients undergoing short-level lumbar fusion surgery from January to November 2021. Given the discharge criteria, a threshold was set according to mean LOS, and two groups were spontaneously formed: LOS shorter than the threshold for discharge (control group, n = 114) and LOS longer or equal to the threshold for discharge (delayed group, 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 control group and 72 in delayed group. Statistical analysis demonstrated that age ≥75 years ( P = .002), female sex ( P 1 day ( P = .027), removal of urinary catheter time >1 day ( P = .019), fusion levels ( P 1 ( P 1(OR 15.936, 95% CI 5.220-48.652, P 1 were independently correlated with prolonged LOS.