ArticleCanadian journal of surgery. Journal canadien de chirurgie2015
Not all total joint replacement patients are created equal: preoperative factors and length of stay in hospital.
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 39 citations in OpenAlex.
- Outcomes following hip and knee replacement in diabetic versus nondiabetic patients and well versus poorly controlled diabetic patients: a prospective cohort study.Acta orthopaedica · 2018Trial
- Comparative Analysis of Preadmission Testing Center and Primary Care Physician Clearance Before Total Joint Arthroplasty.Arthroplasty today · 2026Article
- Construction of prediction models for prolonged length of postoperative hospital stay in patients undergoing primary total hip arthroplasty via direct anterior approach.Frontiers in surgery · 2025Article
- Predictors of postoperative hospital length of stay after total knee arthroplasty.Singapore medical journal · 2024Article
- Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty.Journal of orthopaedic surgery and research · 2023Article
- Fast-track versus conventional surgery in relation to time of hospital discharge following total hip arthroplasty: a single-center prospective study.Journal of orthopaedic surgery and research · 2021Article
- Influence of day of surgery and prediction of LOS > 2 days after fast-track hip and knee replacement.Acta orthopaedica · 2021Article
- The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia.Journal of clinical medicine · 2020Article
- Limited Influence of Comorbidities on Length of Stay after Total Hip Arthroplasty: Experience of Enhanced Recovery after Surgery.Orthopaedic surgery · 2020Article
- Modifiable, Postoperative Risk Factors for Delayed Discharge Following Total Knee Arthroplasty: The Influence of Hypotension and Opioid Use.The Journal of arthroplasty · 2020Article
- Factors influencing postoperative length of stay in an enhanced recovery after surgery program for primary total knee arthroplasty.Journal of orthopaedic surgery and research · 2018Article
- Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.Geriatric orthopaedic surgery & rehabilitation · 2018Review
- Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe conducted a cross-sectional study of primary total joint replacement (TJR) patients to determine predictors for prolonged length of stay (LOS) in hospital to identify patient characteristics that may inform resource allocation, accounting for patient complexity.
methodsPreoperative demographics, medical comorbidities and acute hospital LOS from a consecutive series of primary TJR patients from an academic arthroplasty centre were abstracted. We categorized patients as LOS of 3 or fewer days, 4 days, or 5 or more days to align results with varying LOS benchmarks. To identify predictors for LOS, we used a generalized logistic regression model fitted on an LOS ternary outcome, using LOS of 3 or fewer days as a reference category.
resultsThe sample included 1459 patients: 61.7% total knee and 38.3% total hip. Male sex was predictive of an LOS of 3 or fewer days (4 d: odds ratio [OR] 0.48, 95% confidence interval [CI] 0.364-0.631; ≥ 5 d: OR 0.57, 95% CI 0.435-0.758), as was current smoking status (4 d: OR 0.425, 95% CI 0.274-0.659; ≥ 5 d: OR 0.489, 95% CI 0.314-0.762). Strong predictors of prolonged LOS included total hip versus total knee arthroplasty, age 75 years or older, American Society of Anesthesiologists classification of 3 and 4 and number of cardiovascular comorbidities.
conclusionNot all patients undergoing TJR are equal. The goal should be individual patient-focused care rather than a predetermined LOS that is not achievable for all patients. Hospital resource planning must account for patient complexity when planning future bed management.
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