Bleeding disorders, longer operative time, and nongeneral anesthesia increase are associated with overnight admission after hip arthroscopy.

IF 1.4 4区 医学 Q3 ORTHOPEDICS
Journal of Hip Preservation Surgery Pub Date : 2024-12-25 eCollection Date: 2025-01-01 DOI:10.1093/jhps/hnae038
Jack Zhong, Connor R Crutchfield, Nathan J Lee, John Mueller, Christopher Ahmad, David Trofa, Thomas Sean Lynch
{"title":"Bleeding disorders, longer operative time, and nongeneral anesthesia increase are associated with overnight admission after hip arthroscopy.","authors":"Jack Zhong, Connor R Crutchfield, Nathan J Lee, John Mueller, Christopher Ahmad, David Trofa, Thomas Sean Lynch","doi":"10.1093/jhps/hnae038","DOIUrl":null,"url":null,"abstract":"<p><p>Overnight admission is a rare but major complication after hip arthroscopy (HA), and the paucity of data surrounding its causes limits patient education and quality of care. The purpose of this study was to identify risk factors for an unanticipated overnight admission after HA and assess for associated complications. This analysis queried the American College of Surgeons National Surgical Quality Improvement Program database using Current Procedural Terminology codes to identify hip arthroscopies from 2005 to 2017. Patient demographics, perioperative variables, and comorbidities were compared between ambulatory and nonambulatory patients [length of stay (LOS) ≥ 1] using bivariate analysis. Multivariate stepwise logistic regression then identified independent risk factors of adverse outcomes. Linear regression analyzed correlation of LOS with age, operative time, modified fragility index (mFI-5), and year of operation. A total of 2420 cases were included in this study with 400 (16.5%) overnight admissions. The mean subject age was 40 ± 13.9 years old (58.1% female). Admitted patients generally had higher American Society of Anesthesiologists (ASA) scores and a higher mFI-5 index. Multivariate logistic regression showed that mFI-5 > 0, bleeding disorders, operative time >1.5 h, and nongeneral anesthesia were independent risk factors for prolonged hospital stay. Patients aged 31-40 years had decreased risk of LOS ≥1. Nonambulatory surgery was associated with significantly increased risk for any complication, readmission, wound complication, and venous thromboembolism. This analysis demonstrates that operations >1.5 h and increased medical comorbidities predispose patients to greater risk of being admitted to the hospital after HA. Surgeons should consider these data to optimize controllable factors and patient selection to reduce the risk of postoperative admission.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 1","pages":"54-64"},"PeriodicalIF":1.4000,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051857/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hip Preservation Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jhps/hnae038","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Overnight admission is a rare but major complication after hip arthroscopy (HA), and the paucity of data surrounding its causes limits patient education and quality of care. The purpose of this study was to identify risk factors for an unanticipated overnight admission after HA and assess for associated complications. This analysis queried the American College of Surgeons National Surgical Quality Improvement Program database using Current Procedural Terminology codes to identify hip arthroscopies from 2005 to 2017. Patient demographics, perioperative variables, and comorbidities were compared between ambulatory and nonambulatory patients [length of stay (LOS) ≥ 1] using bivariate analysis. Multivariate stepwise logistic regression then identified independent risk factors of adverse outcomes. Linear regression analyzed correlation of LOS with age, operative time, modified fragility index (mFI-5), and year of operation. A total of 2420 cases were included in this study with 400 (16.5%) overnight admissions. The mean subject age was 40 ± 13.9 years old (58.1% female). Admitted patients generally had higher American Society of Anesthesiologists (ASA) scores and a higher mFI-5 index. Multivariate logistic regression showed that mFI-5 > 0, bleeding disorders, operative time >1.5 h, and nongeneral anesthesia were independent risk factors for prolonged hospital stay. Patients aged 31-40 years had decreased risk of LOS ≥1. Nonambulatory surgery was associated with significantly increased risk for any complication, readmission, wound complication, and venous thromboembolism. This analysis demonstrates that operations >1.5 h and increased medical comorbidities predispose patients to greater risk of being admitted to the hospital after HA. Surgeons should consider these data to optimize controllable factors and patient selection to reduce the risk of postoperative admission.

出血性疾病、较长的手术时间和非全身麻醉增加与髋关节镜术后过夜住院有关。
过夜住院是髋关节镜术后罕见但主要的并发症,其原因数据的缺乏限制了患者教育和护理质量。本研究的目的是确定HA后意外过夜住院的危险因素,并评估相关并发症。该分析使用现行程序术语代码查询美国外科医师学会国家手术质量改进计划数据库,以识别2005年至2017年的髋关节镜检查。采用双变量分析比较门诊和非门诊患者的患者人口统计学、围手术期变量和合并症[住院时间(LOS)≥1]。多变量逐步logistic回归确定了不良结局的独立危险因素。线性回归分析LOS与年龄、手术时间、修正脆性指数(mFI-5)、手术年份的相关性。本研究共纳入2420例,其中400例(16.5%)过夜入院。平均年龄40±13.9岁(58.1%为女性)。入院患者通常有较高的美国麻醉医师协会(ASA)评分和较高的mFI-5指数。多因素logistic回归分析显示,mFI-5、出血性疾病、手术时间>1.5 h、非全麻是延长住院时间的独立危险因素。31-40岁患者的LOS风险降低≥1。非门诊手术与任何并发症、再入院、伤口并发症和静脉血栓栓塞的风险显著增加相关。该分析表明,手术bbb1.5小时和增加的医疗合并症使患者在HA后入院的风险更大。外科医生应考虑这些数据,优化可控因素和患者选择,以降低术后住院风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
20.00%
发文量
45
审稿时长
12 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信