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同住一室对全髋关节或膝关节置换术后住院时间的影响:一项回顾性研究。

The Impact of Room-Sharing on Length of Stay After Total Hip or Knee Arthroplasty: A Retrospective Study.

作者信息

Felice Tong Yui Yee, Karunaratne Sascha, Youlden Daniel, Gupta Sanjeev

机构信息

Sydney Medical Program, University of Sydney, Camperdown, New South Wales, Australia.

Department of Orthopaedics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

出版信息

Arthroplast Today. 2021 Apr 22;8:289-294.e2. doi: 10.1016/j.artd.2021.03.017. eCollection 2021 Apr.

Abstract

BACKGROUND

Prolonged length of stay (LOS) after elective total hip (THA) and knee (TKA) arthroplasty is often associated with worse patient outcomes. Social support through room-sharing has been identified as a factor that may reduce LOS in a hospital setting, but has not yet been examined in an orthopedic population. The aim of this study was to evaluate the effect of single- vs shared-room accommodation after elective TKA or THA on hospital LOS.

METHOD

A retrospective study was conducted using data from hospital medical records at our institution. Patients receiving unilateral, elective THA or TKA over a 2-year period were eligible. Patients were allocated to either a single room or four-bed shared room. The primary outcome was LOS; secondary outcomes included complications, discharge destination, and return to operating theater.

RESULTS

One hundred eighty-five patients (70 THA, 115 TKA; mean age 65.74 ± 10.38, 59% female) were included, of whom 82 were allocated to a single room and 103 to a shared room. There was no statistically significant difference in LOS between the 2 groups (5.18 ± 2.21 days [single] vs 4.88 ± 2.12 days [shared]; mean difference -0.29 [95% CI -0.92-0.33],  = .36). Analysis modeling for multiple confounders found no association among room allocation, LOS, and discharge destination. However, more patients in single rooms required discharge to rehabilitation (27% vs 9%) and return to theater (7% vs 1%).

CONCLUSIONS

Room allocation did not correlate with a difference in LOS in patients undergoing elective THA or TKA.

摘要

背景

择期全髋关节置换术(THA)和全膝关节置换术(TKA)后住院时间延长常与患者预后较差相关。通过合住病房获得的社会支持已被确定为可能缩短住院时间的一个因素,但尚未在骨科患者中进行研究。本研究的目的是评估择期TKA或THA后单人病房与多人病房对住院时间的影响。

方法

利用本机构医院病历数据进行回顾性研究。入选标准为在两年内接受单侧择期THA或TKA的患者。患者被分配到单人病房或四人合住病房。主要结局指标是住院时间;次要结局指标包括并发症、出院去向和返回手术室情况。

结果

共纳入185例患者(70例行THA,115例行TKA;平均年龄65.74±10.38岁,59%为女性),其中82例被分配到单人病房,103例被分配到多人病房。两组患者的住院时间无统计学显著差异(单人病房组为5.18±2.21天,多人病房组为4.88±2.12天;平均差异-0.29[95%CI-0.92-0.33],P=0.36)。对多个混杂因素的分析模型发现,病房分配、住院时间和出院去向之间无关联。然而,单人病房中有更多患者需要出院后进行康复治疗(27%对9%)和返回手术室(7%对1%)。

结论

对于接受择期THA或TKA的患者,病房分配与住院时间差异无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b35c/8167312/280caccee99c/fx1.jpg

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