Drager Justin, Hart Adam, Khalil Jad Abou, Zukor David J, Bergeron Stephane G, Antoniou John
Division of Orthopedic Surgery, McGill University Health Centre, SMBD-Jewish General Hospital, Montreal, QC, Canada.
Division of General Surgery, McGill University Health Centre, Montreal, QC, Canada.
J Arthroplasty. 2016 Feb;31(2):356-61. doi: 10.1016/j.arth.2015.09.014. Epub 2015 Sep 18.
Reducing hospital stay and unplanned hospital readmission of arthroplasty patients has been a topic of recent interest. The aim of the present study was to query the National Surgical Quality Improvement Program database to compare the length of hospital stay (LOS) and the subsequent 30-day hospital readmission rates in patients undergoing primary unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA).
We identified 1340 UKAs and 36,274 TKAs over a 2-year period (2011-2012). Patient demographics, comorbidities, LOS, 30-day postoperative complications, and readmission rates were compared between the groups. Multivariate regression analysis was used to determine the effect of procedure type on LOS and readmission rates.
Unicondylar knee arthroplasty patients had a median LOS of 2 days compared to 3 days for TKAs (P < .001). The readmission rate in the TKA group was nearly double that of the UKA group (4.1% vs 2.2%) (P < .0001). Multivariate regression analysis identified that undergoing a UKA was predictive for a shorter LOS (coefficient -1 day) and was protective for 30-day readmission (odds ratio, 0.60; 95% confidence interval, 0.41-0.88).
Patients undergoing UKA had a shorter LOS and a lower 30-day readmission rate compared to TKA patients. After adjusting for selected cofounders, we demonstrated that undergoing a UKA is a protective factor for 30-day readmission.
缩短关节置换患者的住院时间和计划外再次入院率是近期备受关注的话题。本研究旨在查询国家外科质量改进计划数据库,以比较初次单髁膝关节置换术(UKA)和全膝关节置换术(TKA)患者的住院时间(LOS)及随后的30天内再次入院率。
我们在2年期间(2011 - 2012年)确定了1340例UKA手术和36274例TKA手术。对两组患者的人口统计学特征、合并症、住院时间、术后30天并发症及再次入院率进行了比较。采用多因素回归分析来确定手术类型对住院时间和再次入院率的影响。
单髁膝关节置换术患者的中位住院时间为2天,而TKA患者为3天(P < 0.001)。TKA组的再次入院率几乎是UKA组的两倍(4.1%对2.2%)(P < 0.0001)。多因素回归分析表明,接受UKA手术可预测住院时间较短(系数为 - 1天),并对30天再次入院有保护作用(比值比为0.60;95%置信区间为0.41 - 0.88)。
与TKA患者相比,接受UKA手术的患者住院时间较短,30天再次入院率较低。在对选定的混杂因素进行调整后,我们证明接受UKA手术是30天再次入院的保护因素。