Risk factors for prolonged length of hospital stay following elective hip replacement surgery: a retrospective longitudinal observational study.
| Title: | Risk factors for prolonged length of hospital stay following elective hip replacement surgery: a retrospective longitudinal observational study. |
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| Authors: | Wilson R; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK rebecca.wilson@bristol.ac.uk.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Margelyte R; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Redaniel MT; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Eyles E; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Jones T; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK.; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Penfold C; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Blom A; The University of Sheffield, Sheffield, UK.; Elliott A; Southmead Hospital, Bristol, UK.; Harper A; National Institute for Health and Care Research Applied Research Collaboration South-West Peninsula (PenARC), University of Exeter, Exeter, UK.; Medical School, University of Exeter, Exeter, UK.; Keen T; North Bristol NHS Trust, Westbury on Trym, Bristol, UK.; Pitt M; National Institute for Health and Care Research Applied Research Collaboration South-West Peninsula (PenARC), University of Exeter, Exeter, UK.; Medical School, University of Exeter, Exeter, UK.; Judge A; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. |
| Source: | BMJ open [BMJ Open] 2024 Aug 21; Vol. 14 (8), pp. e078108. Date of Electronic Publication: 2024 Aug 21. |
| Publication Type: | Journal Article; Observational Study; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : BMJ Publishing Group Ltd, 2011- |
| MeSH Terms: | Arthroplasty, Replacement, Hip*/statistics & numerical data ; Length of Stay*/statistics & numerical data ; Elective Surgical Procedures*/statistics & numerical data; Patient Discharge/statistics & numerical data ; Humans ; Female ; Male ; Aged ; Longitudinal Studies ; Retrospective Studies ; Risk Factors ; Middle Aged ; England ; Aged, 80 and over ; Age Factors ; Comorbidity |
| Abstract: | Objectives: Our aim was to identify which patients are likely to stay in hospital longer following total hip replacement surgery.; Design: Longitudinal, observational study used routinely collected data.; Setting: Data were collected from an NHS Trust in South-West England between 2016 and 2019.; Participants: 2352 hip replacement patients had complete data and were included in analysis.; Primary and Secondary Outcome Measures: Three measures of length of stay were used: a count measure of number of days spent in hospital, a binary measure of ≤7 days/>7 days in hospital and a binary measure of remaining in hospital when medically fit for discharge.; Results: The mean length of stay was 5.4 days following surgery, with 18% in hospital for more than 7 days, and 11% staying in hospital when medically fit for discharge. Longer hospital stay was associated with older age (OR=1.06, 95% CI 1.05 to 1.08), being female (OR=1.42, 95% CI 1.12 to 1.81) and more comorbidities (OR=3.52, 95% CI 1.45 to 8.55) and shorter length of stay with not having had a recent hospital admission (OR=0.44, 95% CI 0.32 to 0.60). Results were similar for remaining in hospital when medically fit for discharge, with the addition of an association with highest socioeconomic deprivation (OR=2.08, 95% CI 1.37 to 3.16).; Conclusions: Older, female patients with more comorbidities and from more socioeconomically deprived areas are likely to remain in hospital for longer following surgery. This study produced regression models demonstrating consistent results across three measures of prolonged hospital stay following hip replacement surgery. These findings could be used to inform surgery planning and when supporting patient discharge following surgery.; (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.) |
| Competing Interests: | Competing interests: None declared. |
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| Contributed Indexing: | Keywords: Adult orthopaedics; Hip; Hospitalization; Primary Health Care |
| Entry Date(s): | Date Created: 20240822 Date Completed: 20240822 Latest Revision: 20250730 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11340698 |
| DOI: | 10.1136/bmjopen-2023-078108 |
| PMID: | 39174061 |
| Database: | MEDLINE |
Journal Article; Observational Study; Research Support, Non-U.S. Gov't