Understanding factors that impact the length of stay after total hip arthroplasty - A national in-patient sample-based study.
Comorbidities
Cost of care
Length of stay
Post-operative complications
Predictors of length of stay
Total hip arthroplasty
Journal
Journal of clinical orthopaedics and trauma
ISSN: 0976-5662
Titre abrégé: J Clin Orthop Trauma
Pays: India
ID NLM: 101559469
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
20
12
2022
revised:
15
07
2023
accepted:
15
11
2023
pmc-release:
18
11
2024
medline:
4
12
2023
pubmed:
4
12
2023
entrez:
4
12
2023
Statut:
epublish
Résumé
Total hip arthroplasty (THA) is increasingly used every year; however, there is currently limited information on factors that impact the length of stay (LOS) following the procedure. Longer LOS following THA is met with an increase in the cost of care, necessitating studies to identify factors that may impact LOS. In this retrospective study, we used the Nationwide Inpatient Sample (NIS) database from 2016 to 2019 to analyze the preoperative comorbidities and postoperative complications that impact the LOS following THA. We divided our cohort into patients with a LOS greater than two days, and patients with a LOS less than two days. A total of 367,890 patients were identified in the NIS database who underwent THA during the study period. Of this cohort, 112,288 (30.52%) patients were identified as having a LOS greater than two days, while the remaining 255,602 (69.48%) patients were patients who had a LOS less than two days. Multivariate analysis demonstrated several pre-operative factors, such as diabetes, systemic lupus erythematosus, organ transplant, dialysis, the human immunodeficiency virus, chronic kidney disease, and Parkinson's disease, were independently associated with a higher risk of a LOS greater than two days. The subsequent multivariate analysis for post-operative variables demonstrated that acute renal failure, myocardial infarction, blood loss anemia, blood transfusion, pulmonary embolism, deep vein thrombosis, periprosthetic fracture, periprosthetic mechanical complications, periprosthetic infections, and wound dehiscence were all independently associated with a higher risk of a LOS greater than two days. Several pre-operative comorbidities and postoperative complications were found to increase the likelihood of a LOS greater than two days. In addition, the group with a LOS greater than two days incurred a higher cost of care. This information is useful for providers to make informed decisions regarding patient care and resource utilization for patients undergoing THA, potentially reducing LOS.
Sections du résumé
Background
UNASSIGNED
Total hip arthroplasty (THA) is increasingly used every year; however, there is currently limited information on factors that impact the length of stay (LOS) following the procedure. Longer LOS following THA is met with an increase in the cost of care, necessitating studies to identify factors that may impact LOS.
Methods
UNASSIGNED
In this retrospective study, we used the Nationwide Inpatient Sample (NIS) database from 2016 to 2019 to analyze the preoperative comorbidities and postoperative complications that impact the LOS following THA. We divided our cohort into patients with a LOS greater than two days, and patients with a LOS less than two days.
Results
UNASSIGNED
A total of 367,890 patients were identified in the NIS database who underwent THA during the study period. Of this cohort, 112,288 (30.52%) patients were identified as having a LOS greater than two days, while the remaining 255,602 (69.48%) patients were patients who had a LOS less than two days. Multivariate analysis demonstrated several pre-operative factors, such as diabetes, systemic lupus erythematosus, organ transplant, dialysis, the human immunodeficiency virus, chronic kidney disease, and Parkinson's disease, were independently associated with a higher risk of a LOS greater than two days. The subsequent multivariate analysis for post-operative variables demonstrated that acute renal failure, myocardial infarction, blood loss anemia, blood transfusion, pulmonary embolism, deep vein thrombosis, periprosthetic fracture, periprosthetic mechanical complications, periprosthetic infections, and wound dehiscence were all independently associated with a higher risk of a LOS greater than two days.
Conclusions
UNASSIGNED
Several pre-operative comorbidities and postoperative complications were found to increase the likelihood of a LOS greater than two days. In addition, the group with a LOS greater than two days incurred a higher cost of care. This information is useful for providers to make informed decisions regarding patient care and resource utilization for patients undergoing THA, potentially reducing LOS.
Identifiants
pubmed: 38046927
doi: 10.1016/j.jcot.2023.102284
pii: S0976-5662(23)00192-3
pmc: PMC10687332
doi:
Types de publication
Journal Article
Langues
eng
Pagination
102284Informations de copyright
© 2023 Delhi Orthopedic Association. All rights reserved.
Déclaration de conflit d'intérêts
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare no competing interest in relation to this study.
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