Factors associated with the length of stay in total knee arthroplasty patients with the enhanced recovery after surgery model

J Orthop Surg Res. 2019 Nov 6;14(1):343. doi: 10.1186/s13018-019-1389-1.

Abstract

Objectives: The purpose of this study is to identify the factors that influence the length of stay (LOS) in total knee arthroplasty (TKA) patients with an enhanced recovery after surgery (ERAS) program.

Methods: Information from 167 patients (31 males and 136 females, range from 43 years to 88 years old) who underwent the unilateral elective primary TKA from January 2017 to January 2019 were reviewed retrospectively. Factors were analyzed by single-factor variance and multi-factor linear regression.

Results: By single-factor variance analysis, American Society of Anesthesiologists (ASA) physical status classification system, pre-operation albumin, pre-operation erythrocyte sedimentation rate (ESR), primary and merge diseases, hidden blood loss, and length of operation were correlated with LOS (P < 0.05). Multi-factor linear regression results suggested that gender, ASA class, pre-operation Alb, and pre-operation ESR were associated with LOS (P < 0.05). Moreover, ASA class 3 (B value 4.84), pre-operation Alb < 30 g/L (B value 18.33), and pre-operation ESR > 15 mmol/h (B value 2.21) could increase the LOS, while males (B value - 3.56) had a shortened LOS.

Conclusions: Overall, our research found that female, ASA class 3, pre-operation Alb < 30 g/L, and pre-operation ESR > 15 mmol/h could extend LOS in TKA patients with ERAS.

Keywords: Enhanced recovery after surgery; Factors; Length of stay; Total knee arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / trends*
  • Blood Sedimentation
  • Enhanced Recovery After Surgery*
  • Female
  • Humans
  • Length of Stay / trends*
  • Male
  • Middle Aged
  • Recovery of Function / physiology*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors