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Factors influencing length of hospital stay after primary total knee arthroplasty in a fast-track setting

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The goal of this study was to identify factors prior to surgery that are associated with an increased length of hospital stay after TKA using a fast-track protocol.

Materials and methods

In total, 879 consecutive patients who underwent primary TKA were included in this retrospective cohort study. A length of stay greater than or equal to three nights was considered an increased length of hospital stay. Univariable and multivariable generalized linear mixed models were used to identify potential factors associated with increased length of hospital stay.

Results

Length of hospital stay was significantly associated with age [OR 1.01 (95 % CI 1.01–1.02); p < 0.001], gender [female vs. male, OR 1.07 (95 % CI 1.00–1.15); p = 0.04], ASA [ASA III/IV vs. ASA I, OR 1.22 (95 % CI 1.06–1.39); p = 0.005], living situation (alone vs. together, OR 1.08 (95 % CI 1.00–1.16); p = 0.04], neurological comorbidities [OR 1.14 (95 % CI 1.06–1.23); p < 0.001], musculoskeletal comorbidities [OR 0.91 (95 % CI 0.85–0.97); p = 0.005], anaesthesia [spinal vs. general, OR 0.86 (95 % CI 0.76–0.97); p = 0.02], and weekday of surgery [Thursday vs. Monday, OR 1.12 (95 % CI 1.02–1.23); p = 0.02].

Conclusions

Older age, female gender, ASA III/IV, people living alone, the presence of neurological comorbidities, general anaesthesia and surgery on Thursday were associated with an increased length of hospital stay. In clinical practice, the knowledge of factors associated with an increased length of hospital stay can be used to further optimize peri-operative protocols for patients at risk for an increased length of hospital stay after TKA.

Level of evidence

II.

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Authors and Affiliations

  1. Department of Orthopaedics, Reinier de Graaf Gasthuis, Medical Centre Delft, Reinier de Graafweg 3-11, 2625 AD, Delft, The Netherlands

    Nina M. C. Mathijssen, Hennie Verburg, Carsten C. G. van Leeuwen & Tim L. Molenaar

  2. Radboud University Medical Center, Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Gerjon Hannink

Authors
  1. Nina M. C. Mathijssen
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  2. Hennie Verburg
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  3. Carsten C. G. van Leeuwen
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  4. Tim L. Molenaar
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  5. Gerjon Hannink
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Corresponding author

Correspondence to Nina M. C. Mathijssen.

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Mathijssen, N.M.C., Verburg, H., van Leeuwen, C.C.G. et al. Factors influencing length of hospital stay after primary total knee arthroplasty in a fast-track setting. Knee Surg Sports Traumatol Arthrosc 24, 2692–2696 (2016). https://doi.org/10.1007/s00167-015-3932-x

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  • DOI: https://doi.org/10.1007/s00167-015-3932-x

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