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

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 document...

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Autores principales:	Christian Bredgaard Jensen, Anders Troelsen, Pelle Baggesgaard Petersen, Christoffer Calov JØrgensen, Henrik Kehlet, Kirill Gromov, on behalf of the Centre for Fast-Track Hip and Knee Replacement Collaborative Group
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/038cc4c1d30e4d2484aeae6b1145795a
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spelling	oai:doaj.org-article:038cc4c1d30e4d2484aeae6b1145795a2021-11-26T11:19:48ZInfluence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty1745-36741745-368210.1080/17453674.2021.1968727https://doaj.org/article/038cc4c1d30e4d2484aeae6b1145795a2021-10-01T00:00:00Zhttp://dx.doi.org/10.1080/17453674.2021.1968727https://doaj.org/toc/1745-3674https://doaj.org/toc/1745-3682Background 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 readmission. This should be noted by surgeons operating on patients with high BMI and age.Christian Bredgaard JensenAnders TroelsenPelle Baggesgaard PetersenChristoffer Calov JØrgensenHenrik KehletKirill Gromovon behalf of the Centre for Fast-Track Hip and Knee Replacement Collaborative GroupTaylor & Francis GrouparticleOrthopedic surgeryRD701-811ENActa Orthopaedica, Vol 92, Iss 6, Pp 722-727 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Christian Bredgaard Jensen Anders Troelsen Pelle Baggesgaard Petersen Christoffer Calov JØrgensen Henrik Kehlet Kirill Gromov on behalf of the Centre for Fast-Track Hip and Knee Replacement Collaborative Group Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty
description	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 readmission. This should be noted by surgeons operating on patients with high BMI and age.
format	article
author	Christian Bredgaard Jensen Anders Troelsen Pelle Baggesgaard Petersen Christoffer Calov JØrgensen Henrik Kehlet Kirill Gromov on behalf of the Centre for Fast-Track Hip and Knee Replacement Collaborative Group
author_facet	Christian Bredgaard Jensen Anders Troelsen Pelle Baggesgaard Petersen Christoffer Calov JØrgensen Henrik Kehlet Kirill Gromov on behalf of the Centre for Fast-Track Hip and Knee Replacement Collaborative Group
author_sort	Christian Bredgaard Jensen
title	Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty
title_short	Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty
title_full	Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty
title_fullStr	Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty
title_full_unstemmed	Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty
title_sort	influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/038cc4c1d30e4d2484aeae6b1145795a
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Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty

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