ArticleBMC nursing2026
Relationship between nursing notes sentiment scores and length of hospital stay in elderly knee osteoarthritis patients undergoing total knee arthroplasty: a retrospective observational study.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWith ongoing population aging, the prevalence of knee osteoarthritis (KOA) keeps increasing in the elderly population. For end-stage KOA patients, total knee arthroplasty (TKA) remains the definitive and effective treatment. Although numerous studies have examined factors associated with length of hospital stay (LOS) in TKA patients, these investigations predominantly focus on patient characteristics and surgical variables, often overlooking the "human factor" within the nursing process. This study aimed to examine the association between nursing note sentiment scores and prolonged length of hospital stay (PLOS) for KOA patients undergoing TKA.
methodsIn this retrospective observational study, sentiment analysis of nursing notes from the Medical Information Mart for Intensive Care-IV database was performed using natural language processing methods. Both random forest and AdaBoost algorithms were utilized to assess the significance of variables. Multivariable logistic regression was used to further clarify the relationship between PLOS and continuous/tertiles sentiment scores, and to construct a nomogram model. Quantile regression was utilized to determine dynamic associations between two continuous variables. The receiver operating characteristic curve was utilized to determine the nomogram model's performance.
results648 KOA patients were included, with a median hospital LOS of 3.570 days. Multivariable logistic regression revealed that continuous scaled polarity was negatively associated with PLOS (OR = 0.209, 95%CI: 0.061-0.715). This association persisted when sentiment polarity was converted to a categorical variable (OR
conclusionSentiment polarity was negatively associated with hospital LOS, but this effect was primarily evident following PLOS. Monitoring nurses' sentiment states at critical junctures during inpatient treatment may enhance their motivation and facilitate patient recovery. CLINICAL TRIAL NUMBER: Not applicable.
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