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

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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 ofroutineoutpatient or short-stay observation after PCLR.

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