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Increased hip arthroscopy operative duration is an independent risk factor for overnight hospital admission

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to determine the association between operative duration and short-term complications as well as overnight hospital admission following hip arthroscopy.

Methods

Hip arthroscopy cases from 2006 to 2016 were retrieved from the National Surgical Quality Improvement Program registry, which prospectively collects 30-day postoperative complications. Patients were stratified into the following groups based on procedure length: group 1 (< 60 min), group 2 (60–120 min), and group 3 (> 120 min). Preoperative characteristics were compared across the cohorts. Multivariate regressions were used to compare complication rates and overnight hospital admission between the three groups. Independent risk factors for overnight hospital admission were characterized.

Results

A total of 2129 hip arthroscopy cases were identified. Average operative duration was 99.3 ± 55.7 min. As operative time increased, patients were more likely to be younger, male, and had lower American Society of Anesthesiologists (ASA) class (p < 0.001). Body mass index and comorbidity profiles were similar across the patient cohorts, with the exception of hypertension being more prevalent in the shorter operative time cohort (p < 0.001). Patients in group 3 were more likely to stay overnight in the hospital (26.0%) compared to patients in groups 1 (7.7%) and 2 (10.9%), p < 0.001). All postoperative complication rates were otherwise similar between the cohorts. Independent risk factors for overnight hospital admission included increasing operative time (most notably > 120 min relative to < 60 min, relative risk [RR] = 3.53, 95% CI 2.50–5.00, p < 0.001) and increasing ASA classification (most notably ASA III or IV relative to ASA I, RR = 1.64, 95% CI 1.18–2.27; p = 0.013).

Conclusions

Increasing operative duration was not associated with increased postoperative complications following hip arthroscopy. However, patients were more than three times likely to stay in the hospital overnight if their surgery was longer than 120 min, relative to cases that were less than 60 min.

Level of evidence

III.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA

    Patawut Bovonratwet & Benedict U. Nwachukwu

  2. Department of Orthopaedic Surgery, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY, 10032, USA

    Venkat Boddapati

  3. Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 400, Chicago, IL, 60612, USA

    Daniel D. Bohl, Michael C. Fu & Shane J. Nho

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  1. Patawut Bovonratwet
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  2. Venkat Boddapati
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Correspondence to Patawut Bovonratwet.

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Bovonratwet, P., Boddapati, V., Nwachukwu, B.U. et al. Increased hip arthroscopy operative duration is an independent risk factor for overnight hospital admission. Knee Surg Sports Traumatol Arthrosc 29, 1385–1391 (2021). https://doi.org/10.1007/s00167-020-06170-7

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