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Procedure length is independently associated with overnight hospital stay and 30-day readmission following anterior cruciate ligament reconstruction

Purpose The purpose was to characterize the independent effect of procedure length on the rates of 30-day perioperative complications, hospital readmissions, and overnight hospital stay in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR). We hypothesized that longer...

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Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2020-02, Vol.28 (2), p.432-438
Main Authors: Boddapati, Venkat, Fu, Michael C., Nwachukwu, Benedict U., Camp, Christopher L., Spiker, Andrea M., Williams, Riley J., Ranawat, Anil S.
Format: Article
Language:English
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Summary:Purpose The purpose was to characterize the independent effect of procedure length on the rates of 30-day perioperative complications, hospital readmissions, and overnight hospital stay in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR). We hypothesized that longer procedure length in primary ACLR increases the risk for post-operative complications. Methods Primary ACLR cases from 2005 to 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program registry. Patients were categorized into two cohorts based on procedure length, either less than or greater than 90 min. Two equal-sized propensity-matched cohorts were generated to account for differences in baseline and operative characteristics. Thirty-day clinical outcomes were compared using bivariate analyses between propensity-matched groups that controlled for patient-specific factors and concurrent meniscal repair. Multivariate logistic regression models were used to identify independent predictors of hospital readmission and overnight hospital stay. Results In total, 12,077 ACLR cases were identified. The rate of any 30-day complication was increased in longer procedures relative to shorter procedures (1.6% vs 0.9%, p  = 0.006), as were the rates of returning to the operating room (0.6% vs 0.3%, p  = 0.03), hospital readmission (1.0% vs 0.3%, p  = 0.001), and overnight hospital stay (16.2% vs 6.0%, p  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-019-05622-z