是时候改变我们衡量髋关节和膝关节置换术住院时间的方式了吗？
Is It Time We Changed How We Measure Length of Stay for Hip and Knee Arthroplasty?
作者信息
McCulloch Robert, Cottingham Paul, Chrismas Bryna, Pearce Oliver
机构信息
Departments of Trauma and Orthopaedics, Oxford Rotation (Dr. McCulloch), and the Department of Trauma and Orthopaedics (Dr. Pearce), Milton Keynes University Hospital, Milton Keynes, UK; Services and Solutions Development, Zimmer Biomet, Warsaw, IN (Mr. Cottingham); and the Department of Exercise Physiology, Sport Science Program, College of Arts and Sciences, Qatar University, Doha, Qatar (Dr. Christmas).
出版信息
J Am Acad Orthop Surg Glob Res Rev. 2017 Oct 9;1(6):e032. doi: 10.5435/JAAOSGlobal-D-17-00032. eCollection 2017 Sep.
INTRODUCTION
Patient length of stay (LOS) for lower limb arthroplasty is a frequently quoted outcome measure. However, the use of mean values in days is prone to being skewed by outliers.
METHODS
Between January 2013 and December 2015, patient LOS for primary hip and knee replacement was collected in 1,168 patients. There were two groups: pre- and postinstitution of the Rapid Recovery Program. The hypothesis was that reducing LOS would highlight proportionate differences when using hours as the measuring unit.
RESULTS
Statistical analysis confirmed a significant reduction in LOS between the Enhanced Recovery Program and Rapid Recovery Program ( < 0.001).
DISCUSSION
Use of the median LOS reduces the impact of outliers. Use of hours as the unit of measure of LOS enabled analysis of the time of day of discharge. With decreasing LOS and day-case arthroplasty, a measurement in median hours should become the standard to allow for the detection of subtle changes.
引言
下肢关节置换术患者的住院时间（LOS）是一个经常被引用的结果指标。然而，以天数计算的平均值容易受到异常值的影响而出现偏差。
方法
在2013年1月至2015年12月期间，收集了1168例初次髋关节和膝关节置换患者的住院时间。分为两组：快速康复计划实施前和实施后。假设是当使用小时作为测量单位时，缩短住院时间会突出相应的差异。
结果
统计分析证实，强化康复计划和快速康复计划之间的住院时间有显著缩短（<0.001）。
讨论
使用住院时间中位数可减少异常值的影响。使用小时作为住院时间的测量单位能够分析出院时间。随着住院时间的缩短和日间手术的开展，以中位数小时进行测量应成为检测细微变化的标准。
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