Short-term outcomes associated with drain use in shoulder arthroplasties: a prospective, randomized controlled trial.

Autor: Trofa DP; Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, NY, USA. Electronic address: davidtrofa@gmail.com., Paulino FE; Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, NY, USA., Munoz J; Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, NY, USA., Villacis DC; Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, NY, USA., Irvine JN; Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, NY, USA., Jobin CM; Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, NY, USA., Levine WN; Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, NY, USA., Ahmad CS; Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, NY, USA.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2019 Feb; Vol. 28 (2), pp. 205-211.
DOI: 10.1016/j.jse.2018.10.014
Abstrakt: Background: This study examined the immediate outcomes during the perioperative period associated with drains in the setting of total shoulder arthroplasty or reverse shoulder arthroplasty. We hypothesized that drain use would result in lower postoperative hemoglobin and hematocrit levels that would increase transfusion rates and longer hospital stays that would increase hospital costs.
Methods: The study prospectively randomized 100 patients (55% women; average age, 69.3 years) who underwent total shoulder arthroplasty or reverse shoulder arthroplasty to receive a closed-suction drainage device (drain group, n = 50) or not (control group, n = 50) at the time of wound closure. Basic demographic information and intraoperative and postoperative data were collected.
Results: The groups were similar with respect to basic patient demographics. Postoperatively, drains had no effect on transfusion rates or any perioperative complication (P > .715). There were also no significant differences in hemoglobin or hematocrit levels immediately after surgery or on postoperative day 1. On average, patients were discharged from the hospital 1.6 days and 2.1 days postoperatively in the control and drain groups, respectively (P = .124). The average cost associated for the control cohort's hospital stay was $35,796 ± $13,078 compared with $43,219 ± $24,679 for the drain cohort (P = .063).
Discussion: Drain use after shoulder arthroplasty had no appreciable difference on short-term perioperative outcomes, postoperative anemia, length of hospital stay, or cost. It is possible that the potential negative effects of postoperative drainage are blunted by the routine use of tranexamic acid.
(Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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