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Preoperative pain level and patient expectations predictive of increased hospitalization after THA
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Recently published data demonstrated high preoperative pain levels and patient expectation of discharge to extended-care facilities after total hip arthroplasty significantly predicted increased hospitalization based on a length-of-stay target of 2 days.
Researchers identified 112 patients (median age: 61 years) who underwent total hip arthroplasty (THA) and reviewed their medical records for factors including age, sex, level of pain, BMI, comorbidities, use of assistive devices, history of prior THA or total knee arthroplasty (TKA), history of admission to extended-care facilities (ECFs), patient expectation of discharge destination and home caregiver assistance.
The researchers assessed the relationship between the variables and length of hospital stay using chi-square test of Fisher’s exact test. Following the univariable analysis, the researchers also conducted a multivariable, stepwise logistic regression analysis on factors that were considered statistically significantly associated with length of stay (LOS).
Forty-one patients had recorded use of assistive devices before surgery, eight patients underwent prior THA in contralateral side and 30 patients underwent prior TKA, according to the researchers. Additionally, 104 patients received adequate home care assistance.
Results showed the mean LOS was 2.5 days, with 92 patients discharged home and 20 patients discharged to rehabilitation centers. A significant correlation was observed between LOS and number of comorbidities, prior ECF, caregiver assistance and history of TKA after univariable analyses; however, the correlations were no longer considered significant after multivariable analysis, according to the researchers.
Although age was observed to be a borderline multivariable predictor, the only significant preoperative multivariable variables that remained significant after multivariable analysis were pain level and patient expectation of discharge destination.
Postoperative complications developed in 12 of the patients, indicating there was an association between the LOS and complication development, according to the researchers. ‒ by Monica Jaramillo
Disclosures: Halawi reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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