Article Text
Abstract
Background and Aims Our aim was to identify independent pre-operative factors that determine length of stay (LOS) following elective primary total hip replacement surgery in a large volume tertiary orthopaedic centre.
Methods Data for all patients undergoing elective primary total hip replacement in the Golden Jubilee National Hospital of Glasgow between 1st of January and 31st of December 2018 were prospectively collected; the database was supplemented with variables of interest. The cohort was divided in two groups by the median LOS, and the two group characteristics were compared statistically. A multivariate logistic regression was subsequently performed by including the statistically significant parameters arising from the univariate comparison. Analysis was performed with the use of SPSS.
Results Data for a total of 1746 patients were analysed. Of those 1014 (58.1%) were females. The median age was 68.3 years. Significant cardiopulmonary disease was identified in 318 (18.2%). The mean BMI was 29.6 (SD: 5.5) and the mean pre-operative haemoglobin was 136.5 g/L (SD: 13.7 g/L). The median LOS was 2 days with a cumulative inpatient stay of 4449 days. Age (OR: 1.036; 95% CI: 1.023–1.048), pre-operative haemoglobin (OR: 0.982; 95% CI: 0.973–0.991), gender (OR: 0.698; 95% CI: 0.545–0.894), ASA (OR: 1.828; 95% CI: 1.828–2.902) were found to be independent determinants of the LOS.
Conclusions Age, gender, pre-operative haemoglobin, and ASA are shown to be independent determinants of the LOS for patients undergoing elective primary total hip replacement surgery. On this basis, appropriate peri-operative planning can be undertaken to streamline patient selection and management for fast-tract hip replacement surgery.