Preoperative indicators of length of stay following total hip replacement: a New Zealand-based retrospective, observational study

• Published in: Journal of clinical nursing 2014-07, Vol.23 (13-14), p.2022-2030
• Main Authors: Le Mar, Karen Jane, Whitehead, Dean
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - nursing; comorbidity; Correlation analysis; determinants; discharge; Female; Health Services for the Aged - economics; Humans; Joint replacement surgery; Length of Stay; Male; Middle Aged; New Zealand - epidemiology; Nursing; Nursing care; Patient admissions; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - nursing; preoperative; Retrospective Studies; risk; Risk Factors; total hip replacement; Young Adult
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.12484

Aims and objectives To identify preoperative risk factors that potentially affect postoperative length of stay of patients undergoing total hip replacement. Background With limited health resources and an ageing population, alongside an increasing prevalence of osteoarthritis and the growing need for total hip replacement, reducing length of stay is a mainstay of effective and cost‐efficient orthopaedic practice. Design A retrospective observational study. Methods Data from a convenience sample of 243 patients having undergone an elective unilateral total hip replacement between January 2008–December 2009 were collected. Demographic data were studied and allied against the main preoperative risk factors – with length of stay being the main outcome measure. Results Pearson's correlation demonstrated a moderate positive correlation between age and a longer postoperative stay. The number of comorbidities did not have an impact on length of stay. Demographic findings included almost half the cohort lived with hypertension, and 66% of the available cases (n = 196) were deemed overweight. Conclusions Collecting accurate and comprehensive assessment information relating to preoperative risk factors for total hip replacement, significantly impacts on postoperative outcomes specifically related to length of stay. Relevance to clinical practice In complex healthcare systems, where there is a need for quality client outcomes tempered against limited resources, this study highlights the benefits of accurate preassessment of orthopaedic clients undergoing major surgical intervention against the desirable outcomes of reduced lengths of admission.