Is cost of surgery and hospital length of stay increased for sickle cell disease patients undergoing total joint replacement surgeries? Systematic review and multivariate meta-analysis.

Background: Sickle cell disease (SCD) patients undergo major joint replacement surgeries with significant improvement in quality of life. Previous literature have tried to explore differences in hospital charges and length of stay between patients with and without SCD. The aim of this meta-analysis is to find out if both outcomes are increased for patients with SCD patients compared to those without SCD. Methods: Literature search was conducted and studies that compared hospital charges and length of stay between patients with and without sickle cell disease following major arthroplasties were retrieved. A multivariate meta-analysis was conducted using Random-Effect model with the Restricted Maximum Likelihood (REML) using the Metafor Package in R and Rstudio. Results: Four observational studies were found eligible for the study. The estimated average mean difference based on the random effect model for hospital charges was 7548.50 (95 % CI: 3779.65 to 11317.65) and for length of stay was 2.28 (95 % CI: 1.32 to 3.24) while the prediction interval for the true mean difference for both outcomes were -1810.56 to 16907.56 and -0.01 to 4.57 respectively. Conclusion: This present study showed that hospital charges and length of stay are increased for patients with SCD compared to patients without.