Dacombe P, Harries L, McCann P, Crowther M, Packham I, Sarangi P, Whitehouse M R
Southmead Hospital, Westbury on Trym, Bristol, UK.
Bristol Royal Infirmary, Bristol, UK.
Ann R Coll Surg Engl. 2020 Sep;102(7):493-498. doi: 10.1308/rcsann.2020.0052. Epub 2020 Apr 17.
Shoulder arthroplasty rates are increasing in the UK. No data have been published from a UK centre on predictors of length of inpatient stay following shoulder arthroplasty. This study analyses the length of inpatient stay following shoulder arthroplasty in a high-volume UK centre and identifies predictors of prolonged inpatient stay.
All shoulder arthroplasty cases performed between 2012 and 2018 were identified. A review of case notes and electronic patient records was completed to identify demographic data, Charlson comorbidity score, length of inpatient stay and factors associated with length of stay. Multiple linear regression analysis was conducted to determine which factors were independently associated with length of inpatient stay.
A total of 640 shoulder arthroplasty cases were performed in 566 patients. Median length of stay was two days. Length of stay was predicted by age, sex, chronic kidney disease, congestive cardiac failure, previous myocardial infarction, intraoperative complication and postoperative transfusion.
Increasing age, female sex, chronic kidney disease, congestive cardiac failure, previous myocardial infarction, intraoperative complication and transfusion were independent predictors of increased length of stay. Strategies to reduce perioperative complication and transfusion, and to optimise renal and cardiac comorbidities may reduce overall length of stay for shoulder arthroplasty patients.
在英国，肩关节置换手术的发生率正在上升。英国尚无中心发布关于肩关节置换术后住院时间预测因素的数据。本研究分析了英国一家高手术量中心肩关节置换术后的住院时间，并确定了住院时间延长的预测因素。
确定2012年至2018年间进行的所有肩关节置换手术病例。完成对病例记录和电子病历的审查，以确定人口统计学数据、查尔森合并症评分、住院时间以及与住院时间相关的因素。进行多元线性回归分析，以确定哪些因素与住院时间独立相关。
566例患者共进行了640例肩关节置换手术。中位住院时间为两天。住院时间由年龄、性别、慢性肾病、充血性心力衰竭、既往心肌梗死、术中并发症和术后输血预测。
年龄增加、女性、慢性肾病、充血性心力衰竭、既往心肌梗死、术中并发症和输血是住院时间延长的独立预测因素。减少围手术期并发症和输血以及优化肾脏和心脏合并症的策略可能会缩短肩关节置换患者的总体住院时间。
