Factors influencing length of stay following primary total knee replacement in a UK specialist orthopaedic centre

• Published in: The knee Vol. 20; no. 5; pp. 310 - 315
• Main Authors: Jonas, Sam C, Smith, Hannah K, Blair, Peter S, Dacombe, Peter, Weale, Adrian E
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2013; Elsevier Limited
• Subjects: Academic Medical Centers; Age; Age Factors; Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - methods; ASA; Blood Transfusion - statistics & numerical data; BMI; Body mass index; Cohort Studies; Elective Surgical Procedures - adverse effects; Elective Surgical Procedures - methods; Female; Follow-Up Studies; Hospitals; Humans; Joint surgery; Length of Stay; Male; Middle Aged; Multivariate Analysis; Orthopedics; Postoperative Complications - physiopathology; Postoperative Complications - therapy; Predictive Value of Tests; Prostheses; Retrospective Studies; Risk Assessment; Sex Factors; Surgery; Theater; Time Factors; Total knee replacement; Treatment Outcome; United Kingdom; United Kingdom > UK; Total knee replacement; Age; Length of stay; ASA; BMI
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2012.07.010

Abstract Aim To identify factors significant in influencing LOS following primary TKA in a UK specialist arthroplasty centre. Method We retrospectively reviewed factors affecting LOS of 514 patients who underwent primary TKA in a single specialist arthroplasty centre in the UK over a one-year period. Surgical and patient factors that may influence LOS were recorded. Results The median LOS was 5 days. 85% were discharged within 10 days. Those staying longer were classified as long stay (up to 3 months). The only surgical factor that influenced length of stay was postoperative blood transfusion (p < 0.0001). Females stayed longer as did those who lived in more deprived areas. These factors did not remain significant in multivariate analysis. The other most significant predictors at multivariate analysis were pre-operative patient factors such as poor anaesthetic fitness (ASA3 and ASA4) (p = 0.001), BMI = 30–35 (p = 0.04), BMI > 35 (p = 0.009) and age > 80 (p = 0.01). Conclusion Length of stay is largely due to case mix and this should be considered when planning a local arthroplasty service. Level of evidence 2-II.