Abstract: PURPOSE: To compare the risk factors of postoperative complications between the day surgery and traditional inpatient models of cleft palate surgery. METHODS: A total of 3 040 patients who received one-stage cleft palate repair in the Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital from January 2017 to August 2024 were selected and divided into the day-surgery group (n=453) and the inpatient-surgery group (n=2 587) according to different hospitalization modes. Baseline characteristics, perioperative parameters, and postoperative complication rates were compared between the two groups. Additionally, propensity score matching and multivariate regression analysis were employed to identify differences in risk factors for complications between the two groups. RESULTS: In the primary analysis, the incidence of postoperative complications in the day-surgery group was significantly higher than that in the inpatient-surgery group (17.7% vs 13.1%, P<0.05). However, both the length of hospital stay and treatment costs were significantly lower in the day-surgery group compared to the inpatient-surgery group (P<0.05). After propensity score matching, the incidence of postoperative complications in the day- surgery group was slightly higher than that in the inpatient-surgery group (17.7% vs 12.8%), but this difference did not reach statistical significance (adjusted P=0.077). Subgroup analysis after adjusting for gender, age in months, body mass index, and ASA classification showed that postoperative complications in the inpatient-surgery group were significantly associated with cleft palate type (types 2 and 3) and preoperative comorbidities (P<0.05), with significant interaction effects of preoperative comorbidities (P<0.05). In contrast, no significant associations were found between these factors and complication risk in the day-surgery group (P>0.05). CONCLUSIONS: Cleft palate day surgery can significantly shorten hospital stays and reduce medical costs. The postoperative complication rate is slightly higher than that of the traditional inpatient model, and there is no significant correlation with the postoperative complication risk factors of the traditional inpatient model (cleft palate classification and preoperative comorbidities). Clinically, it is necessary to strengthen monitoring and prevention of postoperative complications after day surgery in a targeted manner.

Key words: Cleft palate repair, Day surgery, Traditional hospitalization mode, Postoperative complications, Risk factors