Incidence and risk factors for extended post-operative length of stay following primary hip arthroplasty in a South African setting

  • Nkanyiso Dlamini University of KwaZulu-Natal
  • Paul Vincent Ryan Inkosi Albert Luthuli Central Hospital
  • Yoshan Moodley University of KwaZulu-Natal
Keywords primary hip arthroplasty, primary hip replacement, South Africa, extended length of stay, risk factors

Abstract

Background: This study sought to determine the incidence of extended post-operative length of stay (EPLoS) and its associated risk factors in South African primary hip arthroplasty patients.


Methods: This was a retrospective chart review study of 185 adults who underwent primary hip arthroplasty at a quaternary South African hospital. Data related to patient, clinical, and surgical characteristics were collected. Post-operative length of stay was calculated as the time (in days) between the dates of surgery and discharge from hospital. We defined EPLoS as any length of stay ≥75th percentile obtained for the entire study population. Data were analysed using univariate and multivariate statistical methods.


Results: The incidence of EPLoS was 28.1% (95% confidence interval – CI: 22.1–35.0%). Risk factors for EPLoS included: female sex (odds ratio – OR: 4.63, 95% CI: 1.74–12.34; p=0.002), patient’s maximum walking distance <100 m (OR: 3.05, 95% CI: 1.05–8.89; p=0.041) and extended duration of surgery (OR: 3.62, 95% CI: 1.31–10.01; p=0.013).


Conclusion: We provide a report of EPLoS and several associated risk factors in South African primary hip arthroplasty patients.


Level of evidence: Level 4

Author Biographies

Nkanyiso Dlamini, University of KwaZulu-Natal

MBChB(UCT), MMed, FC Orth (SA); Consultant orthopaedic surgeon, Department of Orthopaedics, Prince Mshiyeni Memorial Hospital, Durban; and Department of Orthopaedics, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa

Paul Vincent Ryan, Inkosi Albert Luthuli Central Hospital

MBChB(UCT), MMed, FC Orth (SA); Consultant orthopaedic surgeon, Department of Orthopaedics, Inkosi Albert Luthuli Central Hospital, Durban, South Africa

Yoshan Moodley, University of KwaZulu-Natal

PhD; Research fellow, Department of Anaesthetics, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa

Published
2019-01-21
How to Cite
DLAMINI, Nkanyiso; RYAN, Paul Vincent; MOODLEY, Yoshan. Incidence and risk factors for extended post-operative length of stay following primary hip arthroplasty in a South African setting. South African Orthopaedic Journal, [S.l.], p. 40-46, jan. 2019. ISSN 2309-8309. Available at: <http://journal.saoa.org.za/index.php/saoj/article/view/286>. Date accessed: 24 apr. 2019.

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