Increased Surgical Duration Associated With Prolonged Hospital Stay After Isolated Posterior Cruciate Ligament Reconstruction

• Published in: Therapeutics and clinical risk management 2019-01, Vol.15, p.1417-1425
• Main Authors: Swindell, Hasani W, Boddapati, Venkat, Sonnenfeld, Julian J, Trofa, David P, Fleischli, James E, Ahmad, Christopher S, Popkin, Charles A
• Format: Article
• Language: English
• Subjects: Age; american college of surgeons national surgical quality improvement program (nsqip); Body mass index; healthcare expenditures; Hospitalization; Joint and ligament injuries; Knee; Ligaments; operative time; Original Research; Orthopedics; overnight hospital stays; Patients; Postoperative period; Quality control; Quality improvement; Terminology
• ISSN: 1176-6336; 1178-203X; 1178-203X
• DOI: 10.2147/TCRM.S216384

Although often performed using a variety of reconstructive techniques and strategies, no clinically significant differences presently exist between the approaches available for isolated PCL reconstructions. Given the operatively challenging nature of these procedures, there lies a potentially increased risk of postoperative complications and healthcare expenditures. Our investigation sought to identify patient and surgical risk factors associated with prolonged hospital stays following isolated PCL reconstruction and determine the incidence of 30-day complications after PCL reconstruction using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients undergoing isolated PCL reconstructions between 2005 and 2016 were identified in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database using Current Procedural Terminology codes. Baseline patient and operative characteristics were evaluated as possible risk factors for overnight hospital admissions following PCL reconstruction and analyzed using multivariate analyses. A total of 249 patients were identified. Multivariate analyses demonstrated that increased operative duration >120 mins (OR 5.04, CI 2.44-10.40; p 120 mins carried an increased risk of overnight hospital stay after isolated PCL reconstructions. As there are presently minimal significant clinical differences between current PCL reconstruction techniques, improved surgeon familiarity and comfort with a single technique is recommended to decrease operative time and avoid prolonged hospital stays and healthcare expenditures. III, retrospective comparative study.