Analysis Of Influencing Factors Of Prolonging The Length Of Stay After MIS-TILF Surgical Treatment For ? And ? Degree Spondylolisthesis

Objective:To explore the influencing factors of prolonging the length of stay(LOS)after MIS-TLIF surgical treatment for?and?degree spondylolisthesis,and to provide theoretical basis and corresponding measures for optimizing the management of perioperative period and shortening the postoperative LOS measures.Methods:Retrospectively analyze the clinical data of 120 patients with?and?degree lumbar spondylolisthesis treated by MIS-TLIF surgery in the Department of Orthopedics of Gansu Provincial People's Hospital from October 2017 to October 2019,and record the general Information of patients:including gender,age,body mass index(BMI),with or without smoking history,with or without drinking history;preoperative variables:including the American Society of Anesthesiologist(ASA)score,preoperative major comorbidities(including hypertension,diabetes,heart disease,lung disease and preoperative anemia);perioperative variables:including operation time,estimated intraoperative blood loss,postoperative drainage volume,postoperative adverse events,etc.may have an impact on patients'postoperative LOS the elements of.According to LOS?75~thh LOS,postoperative LOS was divided into normal postoperative LOS(LOS<75~thh LOS)and prolonged postoperative LOS(LOS?75~thh LOS).Perform a single factor analysis on these factors that may affect the postoperative LOS prolongation of the patient,screen out the relevant factors that affect the postoperative LOS prolongation of the patient,and then use these selected factors as independent variables for multiple logistic regression analysis to determine their specific impact.Further,through the results of multiple logistic regression analysis,the reasons for the influence of various factors on the postoperative LOS prolongation of patients are explored.Results:A total of 120 patients who met the inclusion and exclusion criteria were included in the study,including 49 males,accounting for 40.8%,and 71 females,accounting for 59.2%.The patients were 39 to 79 years old,with an average age of(59.2±9.6)years.All patients were hospitalized for 5 to 35 days,with an average of(8.4±4.1)days.Their 75~thh LOS was 9 days.According to their 75~thh LOS,the patients were divided into normal LOS group(LOS<9 days)and LOS prolonged group(LOS?9 days).Among 120 patients,87patients had normal postoperative LOS,accounting for 72.5%,and 33 patients had prolonged postoperative LOS,accounting for 27.5%.Through multiple logistic regression analysis,age(p<0.05),preoperative anemia(p<0.05),intraoperative blood loss(p<0.05)and postoperative adverse events(p<0.05)are important factors affecting the prolongation of postoperative LOS Influencing factors.Among them,the effect value of the age factor on the postoperative LOS of the patient is:every 10 years of age,the LOS increases by about 0.8 days;the effect value of the preoperative anemia factor on the postoperative LOS of the patient is:the patient has preoperative anemia the risk of prolonged postoperative LOS is 4.171 times that of patients without anemia before surgery;the effect value of the intraoperative bleeding factor on the postoperative LOS of patients is:for every 100ml increase in intraoperative bleeding,the patient's LOS increases by about 1.6 days;The effect value of post-adverse event factors on patients'postoperative LOS is:patients have postoperative adverse events,and the risk of postoperative LOS prolongation is 5.027 times that of no postoperative adverse events.Conclusion:Age,preoperative anemia,intraoperative blood loss,and postoperative adverse events are important factors affecting the prolonged LOS after MIS-TLIF surgical treatment of patients with lumbar spondylolisthesis of degree?and?.We should pay attention to senior patients.Correcting anemia before surgery,reducing intraoperative blood loss,and preventing postoperative adverse events will shorten postoperative LOS.