Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study

Abdullah, Hairil Rizal; Sim, Yilin Eileen; Ying, Hao; Lin, Geng; Liew, Geoffrey Haw Chieh; Lamoureux, Ecosse L.; Tan, Mann Hong

doi:10.1136/bmjopen-2017-016403

Cited by 92 publications

(91 citation statements)

References 43 publications

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“…A recent observational study found pre‐operative anaemia — defined as haemoglobin concentration < 130 g/L — in 32% of patients undergoing elective TKA, and, based on the results for the orthopaedic surgical cohort from this study, it is likely that most of these patients were iron depleted . A 2017 single‐centre retrospective study similarly reported anaemia in 24% of a similar cohort of patients, and found it was associated with an increased risk of hospital stay in excess of 6 days (unadjusted odds ratio [OR], 1.97; 95% confidence interval [CI], 1.53–2.53; P < 0.001), which escalated further and proportionally with decreasing haemoglobin cconcentration . In another observational study, anaemia was associated with an increased risk of post‐operative complications in aseptic revision joint arthroplasty (OR, 1.45; 95% CI, 1.24–1.70; P < 0.001), mortality (OR, 2.18; 95% CI, 1.09–4.36; P = 0.028), and increased hospital length of stay (adjusted coefficient, 1.02 days; 95% CI, 0.73–1.31; P < 0.001) …”

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confidence: 64%

Selecting and optimising patients for total knee arthroplasty

Miles

Burbury

Story

2019

Medical Journal of Australia

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mentioning

confidence: 64%

Selecting and optimising patients for total knee arthroplasty

Miles

Burbury

Story

2019

Medical Journal of Australia

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“…Seung-Chan Kim et al [12] found a lower incidence of postoperative prosthetic-related complications in the simultaneous THA group. When it turns to TKA, several studies reported a lower rate of complications in the simultaneous TKA group [14,16,19,24,25]. Whereas some studies have reported a higher rate of speci c complications, such as venous thromboembolism (VTE) [7] and myocardial infarction (MI) [26] for the patients older than 65 years in the simultaneous TKA group.…”

Section: Discussionmentioning

confidence: 99%

Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

Hou

Zhang³

et al. 2020

Preprint

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Background Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into three groups: TKA,THA and all patients. Then, we grouping simultaneous bilateral groups and staged bilateral groups in these three groups respectively. Finally, these two sub-groups(simultaneous bilateral groups and staged bilateral groups) were compared between the three groups(TKA, THA, and pooled groups). Results All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621and $16,747.192, p <0.001), respectively; THA groups were $15,046.210 and $16,126.808, ( p =0.003), respectively; pooled groups were $16,506.971and $15,467.561, ( p <0.001), respectively. All costs were presented in the United States dollar. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common co-morbidities and postoperative complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more economical than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.

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“…Prolonged LOS will not only have a negative impact on health outcomes, causing iatrogenic illness easily, but also high hospital occupancy resulted in a resultant loss of efficiency and access, all of which would bring a marked increase in health expenses [21,22]. And this might be explained the relationship between exceeding LOS with high cost, for long LOS unusually followed high costs [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

Hou

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods: A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into three groups: TKA,THA and all patients. Then, we grouping simultaneous bilateral groups and staged bilateral groups in these three groups respectively. Finally, these two sub-groups(simultaneous bilateral groups and staged bilateral groups) were compared between the three groups(TKA, THA, and pooled groups). Results: All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621and $16,747.192, p <0.001), respectively; THA groups were $15,046.210 and $16,126.808, ( p =0.003), respectively; pooled groups were $16,506.971and $15,467.561, ( p <0.001), respectively. All costs were presented in the United States dollar. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common co- morbidities and postoperative complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions: These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more economical than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.

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Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study

Cited by 92 publications

References 43 publications

Selecting and optimising patients for total knee arthroplasty

Selecting and optimising patients for total knee arthroplasty

Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

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