Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track uni- compartmental knee arthroplasty

Authors

  • Christian Bredgaard Jensen Department of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
  • Anders Troelsen Department of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark
  • Pelle Baggesgaard Petersen Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen 2100, Denmark; Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen 2100, Denmark
  • Christoffer Calov Jørgensen Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen 2100, Denmark; Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen 2100, Denmark
  • Henrik Kehlet Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen 2100, Denmark; Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen 2100, Denmark
  • Kirill Gromov Department of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark; Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen 2100, Denmark
  • The Centre for Fast- Track Hip and Knee Replacement Collaborative Group

DOI:

https://doi.org/10.1080/17453674.2021.1968727

Abstract

Background and purpose — The indications for unicompartmental knee arthroplasty (UKA) have become less restrictive and, today, high age and high BMI are not considered contraindications by many surgeons. While the influence of these patient characteristics on total knee arthroplasty is well documented, evidence on UKA is lacking. We investigated the effect of BMI and age on day of surgery (DOS) discharge, prolonged admission, and 90-day readmission following UKA surgery.

Patients and methods — This retrospective cohort study included 3,897 UKA patients operated on between 2010 and 2018 in 8 fast-track arthroplasty centers. Patients were divided into 5 BMI groups and 5 age groups. Differences between groups in the occurrence of DOS discharge, prolonged admission > 2 days, and 90-day readmission was investigated using a chi-square test and mixed-effect models adjusted for patient characteristics using surgical center as a random effect.

Results — Median LOS was 1 day. DOS discharge was achieved in 26% of patients with no statistically significant differences between BMI groups. DOS discharge was less likely in UKA patients aged > 70 years (age 71–80; odds ratio [OR] 0.7 [95% CI 0.6–0.9]). Prolonged admission was not affected by BMI or age in the adjusted analysis. 90-day readmission was more likely in patients with BMI > 35 (OR 1.9 [CI 1.1–3.1]) and patients aged 71–80 (OR 1.5 [CI 1.1–2.1]).

Interpretation — Age > 70 years decreased the likelihood of DOS discharge after UKA. High BMI as well as advanced age increased the likelihood of 90-day readmis- sion. This should be noted by surgeons operating on patients with high BMI and age.

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Author Biography

The Centre for Fast- Track Hip and Knee Replacement Collaborative Group

Behalf of the Centre for Fast- Track Hip and Knee Replacement Collaborative Group a

The Centre for Fast-track Hip and Knee Replacement Collaborative Group: Frank MADSEN, Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark; Torben Bæk HANSEN, Department of Orthopedics, Regional Hospital Holstebro and University of Aarhus, Holstebro, Denmark; Mogens LAURSEN, Aalborg University Hospital Northern Orthopaedic Division, Aalborg, Denmark; Lars Tambour HANSEN, Department of Orthopedics, Sydvestjysk Hospital Esbjerg/Grindsted, Grindsted, Denmark; Per KJÆRSGAARD-ANDERSEN, Department of Orthopedics, Vejle Hospital, Vejle, Denmark; Mikkel Rathsach ANDERSEN, Department of Orthopedics, Gentofte University Hospital, Copenhagen, Denmark; Niels Harry KRARUP , Department of Orthopedics, Viborg Hospital, Viborg, Denmark; and Henrik PALM, Department of Orthopaedic Surgery, Copenhagen University Hospital Bispebjerg, Copenhagen, NV, Denmark.

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Published

2021-08-20

How to Cite

Jensen , C. B., Troelsen, A., Petersen, . P. B., Jørgensen, C. C. ., Kehlet, H., Gromov, K., & Group, T. C. for F.-. T. H. and K. R. C. (2021). Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track uni- compartmental knee arthroplasty. Acta Orthopaedica, 92(6), 722–727. https://doi.org/10.1080/17453674.2021.1968727