Predictors of an increased length of stay following Total Knee Arthroplasty - Survey Report

Objective: To find various preoperative, intraoperative and postoperative factors that predict an increased length of stay in patients following total knee arthroplasty. Methods: The retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised record of patients regardless of gender, co-morbids and age who had undergone a unilateral or bilateral total knee arthroplasty between January 2007 and December 2015. An increased length of stay was defined as >= 75th centile (>= 11 days). Results: Of the 577 patients, 448 (77.6%)were women. Overall, 311(53.9%) patients were aged 56-70 years. Of the total, 100(17.3%) patients stayed for at least 11 days. There was a weak but positive correlation between increasing body mass index and increased length of stay (p=0.017). Following adjusted-multivariate logistic regression analysis, the most significant predictors contributing to an increased length of stay were bilateral knee surgery, postoperative transfusion and postoperative special care unit stay (p<0.05 each). Conclusion: Bilateral total knee arthroplasty, postoperative transfusion and postoperative special care unit stay were found to be associated with an increased length of stay.