Clinical Factors Affecting Length of Stay After 100 Consecutive Cases of Primary Cleft Lip Repair.

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association

PubMedID: 25137604

Oh AK, Magge K, Sauerhammer TM, Kim J, Atnafu M, Boyajian MJ, Rogers GF. Clinical Factors Affecting Length of Stay After 100 Consecutive Cases of Primary Cleft Lip Repair. Cleft Palate Craniofac J. 2014;.
Objective : To analyze the hospital course of 100 consecutive infants after primary cleft lip repair (PCLR) and identify factors related to length of stay (LOS). Design : Retrospective analysis of 100 consecutive infants who were routinely admitted after PCLR. Setting : Tertiary care center. Patients : One hundred consecutive infants undergoing PCLR. Demographic and perioperative data were collected and analyzed. Main Outcome Measure : LOS, planned before data collection. Results : Male:female ratio was 65:35. Seventy-two infants had unilateral cleft lip; syndromic association was documented in 15 patients. Mean age and weight at PCLR were 5.6 ± 4.0 months and 6.7 ± 1.3 kg, respectively. Mean duration of surgery was 2.5 ± 0.9 hours, and mean duration of general anesthesia was 3.4 ± 0.9 hours. A total of 3.3 ± 1.5 mL of intraoperative local anesthetic was used per patient. Intravenous fluids were necessary after transfer from the post-anesthesia care unit to the general ward in 98% of patients. Almost half (44%) of all patients received intravenous morphine 23 hours or more after hospital admission. Mean LOS was 35.8 ± 13.9 hours. No association was identified between patient demographic factors and LOS. Multivariate linear regression models identified significant positive correlation between LOS and duration of general anesthesia (P = .002). Greater volume of postoperative oral intake (P = .000) and higher acetaminophen dosage on the floor (P = .000) correlated with decreased LOS. Conclusions : This study identifies perioperative factors associated with LOS. Our findings question the safety of routine outpatient or short-stay observation after PCLR.