Limited Influence of Comorbidities on Length of Stay after Total Hip Arthroplasty: Experience of Enhanced Recovery after Surgery
| Autor: | Ze-Yu Luo, Haoyang Wang, Zhi‐min Liang, Zichuan Ding, Bing Xu, Zongke Zhou |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate statistics Blood transfusion Arthroplasty Replacement Hip medicine.medical_treatment Osteoporosis Comorbidity Logistic regression Patient Readmission Disability Evaluation 03 medical and health sciences 0302 clinical medicine lcsh:Orthopedic surgery Risk Factors Internal medicine Diabetes mellitus Humans Medicine Orthopedics and Sports Medicine Enhanced recovery after surgery Aged Retrospective Studies 030222 orthopedics Clinical Article business.industry Odds ratio Middle Aged medicine.disease lcsh:RD701-811 predictors Harris Hip Score Clinical Articles Length of stay Female Total hip arthroplasty Surgery business 030217 neurology & neurosurgery |
| Zdroj: | Orthopaedic Surgery, Vol 12, Iss 1, Pp 153-161 (2020) Orthopaedic Surgery |
| ISSN: | 1757-7861 1757-7853 |
| DOI: | 10.1111/os.12600 |
| Popis: | Objectives To identify predictors of length of stay (LOS) after total hip arthroplasty (THA) in an enhanced recovery after surgery (ERAS) program and evaluate the safety and cost-efficiency of the ERAS program with reduced LOS for unselected patients in a Chinese population. Methods A total of 311 consecutive, unselected patients undergoing primary THA at a single institution were retrospectively reviewed and divided into two groups: LOS ≤ 3 and LOS > 3 group. All patients were managed with the same ERAS protocol and went back home after discharge. Multivariate logistic regression analysis was used to determine independent risk factors for LOS > 3. Harris Hip Score at 90-day follow-up, 90-day readmission rate, and hospitalization costs were compared between two groups. Results Multivariate regression analysis identified female gender (odds ratio [OR] = 2.623), living alone (OR = 4.127), and primary osteoarthritis of hip (OR = 3.565) to be correlated with LOS > 3. Preoperative hemoglobin (HB), postoperative HB, drain use, blood transfusion, diabetes, respiratory disease, osteoporosis, number of comorbidities, and CCI score showed no significant influence on LOS after adjusting for other risk factors in the multivariate model. Harris Hip Score and readmission rate at 90-day follow-up showed no significant differences between two groups. Patients in LOS > 3 group had approximately 3948.6 Chinese yuan higher hospital costs. Conclusion Female gender, living alone, and primary osteoarthritis of hip were identified as independent risk factors for prolonged LOS. The experience from our institution suggested aggressive management of comorbidities in the ERAS program can minimize the influence of comorbidities on LOS. The safety, efficiency, and costs-saving benefits of the ERAS program with reduced LOS for unselected patients was confirmed in this study. |
| Databáze: | OpenAIRE |
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