Background The length of hospital stay (LOS) has become a valuable outcome measure of any operation, and it also directly impacts hospital cost.
Objectives To identify risk factors for LOS after total knee arthroplasty (TKA) in rheumatoid arthritis (RA) and osteoarthritis (OA) patients.
Methods A retrospective study involving 507 consecutive patients undergoing TKA was conducted during a five-year period from January 2010 to December 2014 (mean age 72 years, 433 females, 82 RA patients, and 58 bilateral TKA). The diagnosis of deep vein thrombosis (DVT) was based on ultrasonography.
Multiple linear regression analysis was performed to identify the variables predictive of prolonged LOS and operative time. Multiple logistic regression analysis was performed to analyze the risk factors for postoperative DVT (dependent variables: gender, age, BMI, RA, operative time, antiplatelet agents, cementless TKA, and bilateral TKA).
Results Of the patients undergoing TKA, the mean LOS was 26 days, and the mean operative time was 73 minutes. The results of the multiple linear regression analysis indicated that female gender (P=0.006), age (P<0.001), higher BMI (P=0.03), operative time (P=0.001), and bilateral TKA (P=0.009) were risk factors for prolonged LOS. A subanalysis of operative time revealed that male gender (P=0.01) and BMI (P=0.03) were associated with longer operative time.
A total of 195 (38.5%) cases were DVT positive. Multivariate logistic regression analysis revealed that osteoarthritis (P=0.03) and cementless TKA (P=0.01) were risk factors for DVT after TKA.
Conclusions Female gender, age, higher BMI, operative time, and bilateral TKA were risk factors for longer LOS. Male gender and higher BMI were risk factors for longer operative time. Osteoarthritis and cementless TKA were risk factors for DVT. Further research investigating the risk factors for longer LOS is needed to reduce total hospital costs.
Disclosure of Interest None declared
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