Factors associated with prolonged length of stay following a total knee replacement in patients aged over 75
Factors associated with prolonged length of stay following a total knee replacement in patients aged over 75
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DOI：
10.1007/s00264-012-1538-1
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发表时间：
2012-08-01
影响因子：
2.7
通讯作者：
Khanduja, Vikas
中科院分区：
文献类型：
--
作者：
Raut, Shruti;Mertes, Stephan Christian;Khanduja, Vikas
本研究旨在探讨75岁以上接受全膝关节置换术(TKR)患者住院时间延长的相关因素。研究对象为2008年1月至2009年2月在我所接受TKR的75岁以上患者(n=112)。确定了先前显示的影响住院时间的患者和手术因素。回顾了患者的病历，了解了每一项的细节，并分析了它们对住院时间的影响。采用Mann-Whitney U检验或Kruskall-Wallis检验分析离散数据对术后住院时间的影响，并用Spearman等级相关系数分析连续数据。在95%的置信度水平下，与住院时间相关的因素如下：患者年龄、术前活动能力和是否使用助行器、BMI、患者是否能够在手术后24小时或48小时内活动、患者首次步行10米并达到90摄氏度主动屈膝的当天、术前和术后血红蛋白以及是否需要输血。围手术期的血红蛋白浓度、术后早期活动不到位和术后并发症(包括需要输血)似乎是75岁以上患者长期住院的重要因素。
The aim of this study was to examine factors associated with a prolonged length of stay (LOS) in patients over 75 undergoing a total knee replacement (TKR).Patients over 75 undergoing a TKR at our institution from January 2008 to February 2009 were identified (n = 112). Patient and operative factors previously shown to affect length of stay were identified. Patient notes were reviewed for details on each of these and data analysed for their effect on length of stay. Discrete data were analysed for their effect on post-operative length of stay using either the Mann-Whitney U test or the Kruskall-Wallis test and continuous data analysed with the Spearman's rank correlation coefficient.The following factors were associated with length of stay at the 95 % confidence level: patient age, pre-operative mobility and the use of walking aids, BMI, whether the patient was able to mobilise within 24 or 48 hours of the surgery, the day on which the patient first walked ten metres and achieved 90A degrees active knee flexion, pre and post-operative haemoglobin and the need for a blood transfusion.Pre-operative use of walking aids, peri-operative haemoglobin concentration, failure to mobilise early following the operation and post-operative complications (including the need for a blood transfusion) seem to be the significant factors associated with a prolonged stay in hospital in the over 75 year olds.