The Impact of Room-Sharing on Length of Stay After Total Hip or Knee Arthroplasty: A Retrospective Study.
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ABSTRACT: Background
Prolonged length of stay (LOS) after elective total hip (THA) and knee (TKA) arthroplasty is often associated with worse patient outcomes. Social support through room-sharing has been identified as a factor that may reduce LOS in a hospital setting, but has not yet been examined in an orthopedic population. The aim of this study was to evaluate the effect of single- vs shared-room accommodation after elective TKA or THA on hospital LOS.Method
A retrospective study was conducted using data from hospital medical records at our institution. Patients receiving unilateral, elective THA or TKA over a 2-year period were eligible. Patients were allocated to either a single room or four-bed shared room. The primary outcome was LOS; secondary outcomes included complications, discharge destination, and return to operating theater.Results
One hundred eighty-five patients (70 THA, 115 TKA; mean age 65.74 ± 10.38, 59% female) were included, of whom 82 were allocated to a single room and 103 to a shared room. There was no statistically significant difference in LOS between the 2 groups (5.18 ± 2.21 days [single] vs 4.88 ± 2.12 days [shared]; mean difference -0.29 [95% CI -0.92-0.33], P = .36). Analysis modeling for multiple confounders found no association among room allocation, LOS, and discharge destination. However, more patients in single rooms required discharge to rehabilitation (27% vs 9%) and return to theater (7% vs 1%).Conclusions
Room allocation did not correlate with a difference in LOS in patients undergoing elective THA or TKA.
SUBMITTER: Felice Tong YY
PROVIDER: S-EPMC8167312 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionThe objective of this study was to assess the number and magnitude of preoperative expectations and to correlate them with the degree of satisfaction expressed one year after Total Hip Arthroplasty (THA) or Total Knee Arthroplasty (TKA), in patients with severe and painful osteoarthritis (OA).Materials and methodsPreoperative expectations (within 20 days prior to surgery) and postoperative satisfaction (one year after the intervention) were measured using the previously validated French version of the Hospital for Special Surgery Hip or Knee Replacement Expectations Survey. Postoperative satisfaction was measured using a specific scale, following the same methodology as that used for the assessment of expectations. Prediction of the satisfaction of the patients was performed using multivariate linear regression modelling.ResultsA total of 138 patients (80 THA and 58 TKA) completed the two parts of the study. The expectations score (mean ± SD) (range 0-100) was 72.58 ± 12.63 before THA and 69.10 ± 13.72 before TKA (p = 0.13). The number of expectations expressed was 14.34 ± 1.32 (out of a potential maximum of 18) before THA and 14.70 ± 2.29 (out of a potential maximum of 19) before TKA. After 1 year, THA generated a significantly higher degree of satisfaction compared to TKA (69.70 ± 14.46 v 60.44 ± 17.54, p<0.001) (range 0-100). The pre-operative expectations score was the single best positive predictor of the post-surgery satisfaction assessment both for TKA and THA.ConclusionPatients undergoing total joint arthroplasty for end-stage OA have a high level of expectations, before both THA and TKA. While both types of interventions significantly improve essential and non-essential activities, the rate of satisfaction is significantly greater post THA. Preoperative expectations are a major contributor to the final degree of satisfaction, one year after surgery. These results re-emphasize the need for an optimal preoperative interaction between health care providers and patients, to allow patients a chance to foresee a reasonable outcome after TJA.
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Project description:BackgroundThe length of in-hospital stay (LOS) is an important measure of efficiency in the use of hospital resources and care quality outcomes after orthopaedic surgery. This study investigated the influence of patients' characteristics including demographic factors and the presence of comorbid preoperative depression on LOS after primary total knee arthroplasty (TKA).MethodsData were extracted from the California Healthcare Cost and Utilization Project database for hospital discharges after primary TKA for adults aged 50 years and older from 2007 to 2010 (n = 133,603). LOS was defined as the difference in days between the date of admission and the date of discharge. We included demographic data (age, sex, race), comorbidity of depression, and years of admission as covariates in the multivariable model. Negative binomial regression was used to model the effect(s) of covariates on the LOS. As a secondary analysis, the association of covariates with the extended LOS (>9 days) was also investigated using logistic regression.ResultsOur study showed that female sex, age, Medicaid insurance, and race were associated with a longer LOS. Most importantly, a diagnosis of depression was associated with a significantly longer LOS (1.05 times longer: 95% CI: 1.04-1.06) and was independently associated with 1.83 times higher odds (95% CI: 1.50-2.23) of belonging to the extended LOS group. Compared to 2007, significant reductions of both LOS and a longer LOS were noted throughout all later years from 2008 to 2010.ConclusionsOur study revealed that a diagnosis of depression and patient's characteristic such as age, female sex, Medicaid, nonwhite race resulted in a statistically significant increased LOS. These findings can be useful for planning and resource allocation for total knee replacement programs.
| S-EPMC7083721 | biostudies-literature
Project description:BackgroundThe length of in-hospital stay (LOS) is an important measure of efficiency in the use of hospital resources and care quality outcomes after orthopaedic surgery. This study investigated the influence of patients' characteristics including demographic factors and the presence of comorbid preoperative depression on LOS after primary total knee arthroplasty (TKA).MethodsData were extracted from the California Healthcare Cost and Utilization Project database for hospital discharges after primary TKA for adults aged 50 years and older from 2007 to 2010 (n = 133,603). LOS was defined as the difference in days between the date of admission and the date of discharge. We included demographic data (age, sex, race), comorbidity of depression, and years of admission as covariates in the multivariable model. Negative binomial regression was used to model the effect(s) of covariates on the LOS. As a secondary analysis, the association of covariates with the extended LOS (>9 days) was also investigated using logistic regression.ResultsOur study showed that female sex, age, Medicaid insurance, and race were associated with a longer LOS. Most importantly, a diagnosis of depression was associated with a significantly longer LOS (1.05 times longer: 95% CI: 1.04-1.06) and was independently associated with 1.83 times higher odds (95% CI: 1.50-2.23) of belonging to the extended LOS group. Compared to 2007, significant reductions of both LOS and a longer LOS were noted throughout all later years from 2008 to 2010.ConclusionsOur study revealed that a diagnosis of depression and patient's characteristic such as age, female sex, Medicaid, nonwhite race resulted in a statistically significant increased LOS. These findings can be useful for planning and resource allocation for total knee replacement programs.
| S-EPMC7083721 | biostudies-literature
Project description:BackgroundThe length of in-hospital stay (LOS) is an important measure of efficiency in the use of hospital resources and care quality outcomes after orthopaedic surgery. This study investigated the influence of patients' characteristics including demographic factors and the presence of comorbid preoperative depression on LOS after primary total knee arthroplasty (TKA).MethodsData were extracted from the California Healthcare Cost and Utilization Project database for hospital discharges after primary TKA for adults aged 50 years and older from 2007 to 2010 (n = 133,603). LOS was defined as the difference in days between the date of admission and the date of discharge. We included demographic data (age, sex, race), comorbidity of depression, and years of admission as covariates in the multivariable model. Negative binomial regression was used to model the effect(s) of covariates on the LOS. As a secondary analysis, the association of covariates with the extended LOS (>9 days) was also investigated using logistic regression.ResultsOur study showed that female sex, age, Medicaid insurance, and race were associated with a longer LOS. Most importantly, a diagnosis of depression was associated with a significantly longer LOS (1.05 times longer: 95% CI: 1.04-1.06) and was independently associated with 1.83 times higher odds (95% CI: 1.50-2.23) of belonging to the extended LOS group. Compared to 2007, significant reductions of both LOS and a longer LOS were noted throughout all later years from 2008 to 2010.ConclusionsOur study revealed that a diagnosis of depression and patient's characteristic such as age, female sex, Medicaid, nonwhite race resulted in a statistically significant increased LOS. These findings can be useful for planning and resource allocation for total knee replacement programs.
| S-EPMC7083721 | biostudies-literature
Project description:BACKGROUND:Decreasing the length of hospital stay is an ideal course of action to appropriately allocate medical resources. The aim of this retrospective study was to identify perioperative factors that may decrease the length of hospital stay (LOS). METHODS:In this study, we collected the data on 1112 patients who underwent primary total knee arthroplasty surgery (TKAs) at our institution from Jan 1, 2011 to Nov 31, 2017. Based on the published literature, 16 potential factors (12 preoperative variables, 1 intraoperative variable, and 3 postoperative variables) were investigated. The patients requiring a hospital stay longer than the mean LOS (8?days) were defined as patients with a prolonged LOS. The factors with a P value less than 0.1 in the univariate analysis were further analysed in a multivariate model. An ordinal regression was used to determine independent risk factors for a prolonged LOS. RESULTS:The mean LOS was 8.3?days (±4.3), with a range of 2 to 30?days. Sixteen variables were analysed by univariate analysis, and 11 of them had p?<?0.1 and were included in the multivariable model. Finally, 9 factors were found to be associated with a prolonged LOS. Among the 9 variables, 2 were surgery-related factors (operative time and intraoperative blood loss), and 3 were patient-related factors (age, ASA classification and neurological comorbidities). CONCLUSION:In this study, we found that the clinical protocol, complications, the patient's age, the ASA classification, neurological comorbidities, the operative time, the ward, intraoperative blood loss and the surgeon were all factors contributing to a prolonged LOS. In clinical practice, these factors provide important information for the surgeon and are useful for identifying patients with a high risk of a prolonged LOS.
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