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Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

30.12.2015 | Knee

Length of stay and its impact upon functional outcomes following lower limb arthroplasty

verfasst von: Timothy M. Brock, Paul N. Baker, Steven Rushton, Michelle Bardgett, David Deehan

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 9/2017

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Abstract

Purpose

The aim was to investigate the interplay between patient characteristics and (1) length of hospital stay and (2) one-year patient-reported outcome following total knee and hip arthroplasty.

Methods

Event (survival) analysis and structural equation modelling were performed for 1001 patients undergoing knee (n = 566) and hip (n = 435) arthroplasty in a single institution.

Results

Age, body mass index and co-morbidities were independent predictors of length of stay in both event analysis and structural equation modelling. These patient characteristics and type of arthroplasty had both small direct and indirect effects on patient-reported outcome measures at one year. Length of stay had a small effect (<2 %) in SF-36 scores at one year.

Conclusion

Predictors that influence length of stay also impact on one-year post-operative outcome and therefore should be taken into account during patient selection and discharge planning.

Level of evidence

Retrospective cohort study, Level III.

Antrobus JD, Bryson GL (2011) Enhanced recovery for arthroplasty: good for the patient or good for the hospital? Can J Anaesth 58(10):891–894CrossRefPubMed

Archer S, Montague J, Bali A (2014) Exploring the experience of an enhanced recovery programme for gynaecological cancer patients: a qualitative study. Perioper Med (Lond) 3(1):2CrossRef

Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840PubMed

Bragstad LK, Kirkevold M, Hofoss D, Foss C (2012) Factors predicting a successful post-discharge outcome for individuals aged 80 years and over. Int J Integr Care 12:4CrossRef

Gandek B (2015) Measurement properties of the Western Ontario and McMaster Universities Osteoarthritis Index: a systematic review. Arthritis Care Res (Hoboken) 67(2):216–229CrossRef

Hayes JH, Cleary R, Gillespie WJ, Pinder IM, Sher JL (2000) Are clinical and patient assessed outcomes affected by reducing length of hospital stay for total hip arthroplasty? J Arthroplast 15(4):448–452CrossRef

Higuera CA, Elsharkawy K, Klika AK, Brocone M, Barsoum WK (2011) 2010 Mid-America Orthopaedic Association Physician in Training Award: predictors of early adverse outcomes after knee and hip arthroplasty in geriatric patients. Clin Orthop Relat Res 469(5):1391–1400CrossRefPubMedPubMedCentral

Husted H, Holm G, Jacobsen S (2008) Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients. Acta Orthop 79(2):168–173CrossRefPubMed

Jonas SC, Smith HK, Blair PS, Dacombe P, Weale AE (2013) Factors influencing length of stay following primary total knee replacement in a UK specialist orthopaedic centre. Knee 20(5):310–315CrossRefPubMed

10.

Jones EL, Wainwright TW, Foster JD, Smith JR, Middleton RG, Francis NK (2014) A systematic review of patient reported outcomes and patient experience in enhanced recovery after orthopaedic surgery. Ann R Coll Surg Engl 96(2):89–94CrossRefPubMedPubMedCentral

11.

Kehlet H, Wilmore DW (2002) Multimodal strategies to improve surgical outcome. Am J Surg 183(6):630–641CrossRefPubMed

12.

Khan SK, Malviya A, Muller SD, Carluke I, Partington PF, Emmerson KP, Reed MR (2014) Reduced short-term complications and mortality following enhanced recovery primary hip and knee arthroplasty: results from 6000 consecutive procedures. Acta Orthop 85(1):26–31CrossRefPubMedPubMedCentral

13.

Machin JT, Phillips S, Parker M, Carrannante J, Hearth MW (2013) Patient satisfaction with the use of an enhanced recovery programme for primary arthroplasty. Ann R Coll Surg Engl 95(8):577–581CrossRefPubMedPubMedCentral

14.

Maradit-Kremers H, Visscher SL, Kremers WK, Naessens JM, Lewallen DG (2014) Obesity increases length of stay and direct medical costs in total hip arthroplasty. Clin Orthop Relat Res 472(4):1232–1239CrossRefPubMed

15.

McDonald DA, Siegmeth R, Deakin AH, Kinninmonth AW, Scott NB (2012) An enhanced recovery programme for primary total knee arthroplasty in the United Kingdom-follow up at one year. Knee 19(5):525–529CrossRefPubMed

16.

NHS Group (2013) Enhanced recovery care pathway—a better journey for patients seven days a week and a better deal for the NHS. Progress review 2012/2013. NHS improving quality. http://www.nhsiq.nhs.uk/8846.aspx

17.

NHS Group (2013) The NHS outcomes framework 2014/2015. Department of Health. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/256456/NHS_outcomes.pdf

18.

Olthof M, Stevens M, Bulstra SK, van den Akker-Scheek I (2014) The association between comorbidity and length of hospital stay and costs in total hip arthroplasty patients: a systematic review. J Arthroplast 29(5):1009–1014CrossRef

19.

Paans N, Stevens M, Wagenmakers R, van Beveren J, van der Meer K, Bulstra SK, van den Akker-Scheek I (2012) Changes in body weight after total hip arthroplasty: short-term and long-term effects. Phys Ther 92(5):680–687CrossRefPubMed

20.

Ruta DA, Abdalla MI, Garratt AM, Coutts A, Russell IT (1994) SF 36 health survey questionnaire: I. reliability in two patient based studies. Qual Health Care 3(4):180–185CrossRefPubMedPubMedCentral

21.

Savaridas T, Serrano-Pedraza I, Khan SK, Martin K, Malviya A, Reed MR (2013) Reduced medium-term mortality following primary total hip and knee arthroplasty with an enhanced recovery program. A study of 4500 consecutive procedures. Acta Orthop 84(1):40–43CrossRefPubMedPubMedCentral

22.

Scott NB, McDonald D, Campbell J, Smith RD, Carey AK, Johnston IG, James KR, Breusch SJ (2013) The use of enhanced recovery after surgery (ERAS) principles in Scottish orthopaedic units—an implementation and follow-up at 1 year, 2010–2011: a report from the Musculoskeletal Audit, Scotland. Arch Orthop Trauma Surg 133(1):117–124CrossRefPubMed

23.

Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483CrossRefPubMed

24.

Wasielewski RC, Weed H, Prezioso C, Nicholson C, Puri RD (1998) Patient comorbidity: relationship to outcomes of total knee arthroplasty. Clin Orthop Relat Res 356:85–92CrossRef

Titel: Length of stay and its impact upon functional outcomes following lower limb arthroplasty
verfasst von: Timothy M. Brock
Paul N. Baker
Steven Rushton
Michelle Bardgett
David Deehan
Publikationsdatum: 30.12.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 9/2017
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-015-3914-z

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