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Can the Length of Hospital Stay After Total Hip Arthroplasty be Predicted by Preoperative Physical Function Characteristics?

van Aalst, Michiel J.H. PT, MSc; Oosterhof, Jan PT, PhD; Nijhuis-van der Sanden, Maria W.G. PT, PhD; Schreurs, B. Wim MD, PhD

American Journal of Physical Medicine & Rehabilitation: June 2014 - Volume 93 - Issue 6 - p 486–492
doi: 10.1097/PHM.0000000000000054
Original Research Articles

Objective The aim of the present study was to identify independent preoperative hip function characteristics sensitive for preoperative intervention that are predictive of an extended length of hospital stay (LOS) after primary total hip arthroplasty (THA).

Design This is a longitudinal cohort study. A retrospective chart analysis was conducted on prospectively collected data of patients (158) who underwent unilateral primary elective cemented THA in a 4-yr period. The main outcome measure was LOS after primary THA.

Results The median LOS was 6.0 days. The authors found an 18.5% increased chance of requiring an LOS of more than 6 days (odds ratio, 2.15; 95% confidence interval, 1.03–4.50) for the patients who needed to use a walking aid preoperatively and a 23.6% increased chance (odds ratio, 2.74; 95% confidence interval, 1.31–5.74) for the patients who had difficulties managing stairs. Sex, age, body mass index, comorbidity, and preoperative pain did not reach the level of significance in the multivariate analysis.

Conclusions Patients who are at risk for a longer stay in the hospital after THA can be identified preoperatively on simple physical function characteristics. These findings enable the identification of appropriate patients for preoperative training to improve functional recovery and decrease the LOS after primary THA.

From the Department of Orthopaedic Surgery (MJHvA, JO, MWGN-vdS, BWS) and Department of IQ Healthcare (MWGN-vdS), Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.

All correspondence and requests for reprints should be addressed to: Jan Oosterhof, PT, PhD, Department of Orthopedic Surgery 645, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins