Inpatient Cruciate Ligament Reconstruction in the United States: A Nationwide Database Study From 1998 to 2010

Scillia, Anthony J.; Issa, Kimona; Boylan, Matthew R.; McDermott, James D.; McInerney, Vincent K.; Patel, Deepak V; Mont, Michael A.; Festa, Anthony

doi:10.3928/01477447-20151222-18

Cited by 5 publications

(8 citation statements)

References 12 publications

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“…ACLR performed in outpatient ambulatory surgery centres has been beneficial in several aspects, including higher patient satisfaction[ 22 ] and cost reduction[ 23 ] compared to patients operated on an inpatient setting. Moreover, Lyman et al[ 8 ] reported that rates of readmission within ninety days were significantly higher among patients who had undergone an inpatient ACLR.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register

et al. 2018

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PurposeThe aims of this study are to describe the epidemiological characteristics of anterior cruciate ligament reconstructions in a private hospital in Brazil and to determine trends in medical practice for comparison with previous studies.MethodsWe retrospectively reviewed the anterior cruciate ligament institutional register to obtain data from all patients who underwent primary anterior cruciate ligament reconstruction from July 2014 to June 2016. Descriptive statistics were used to summarize the sample. Specific statistical tests were used to assess associations between the meniscal lesion and other variables.ResultsDuring the study period, 72.6% out of 500 patients were male. The mean age at surgery was 35.1 years. The mean age was higher among females than among males (37.3 ± 12.1 vs 34.3 ± 10.8 years). The median time from injury to surgery was 44 days. The most common femoral and tibial fixations used were suspensory fixation (60.8%) and interference screw (96%), respectively. The most commonly used graft was hamstring tendon (70.2%), followed by bone-patellar tendon-bone (28.8%). A meniscal lesion was noted in 44.8% of cases. Partial meniscectomy was performed in 69.5% of meniscal lesions, and meniscal repair was performed in 14.1% of lesions. The mean length of hospital stay was 1.4 days. The proportion of men in the group of patients with an associated meniscal lesion was higher than that in the group of patients without a meniscal lesion (p = 0.007).ConclusionsIn this study, we identified that the vast majority of surgeries were performed in male patients in all age groups, and patients older than 30 years and with a short time from injury to surgery predominated. Concerning surgical technique, we noted a low rate of meniscal repair and a higher preference for the use of hamstring graft and suspensory fixation on the femoral side.

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Section: Discussionmentioning

confidence: 99%

“…Other studies that also evaluated this parameter found a similar result. Scillia et al[ 23 ] evaluated only inpatient reconstructions in the US from 1998 to 2010 and reported that the mean length of stay was 1.6 days during the study period. The authors also identified a significant increase in total admission costs per case.…”

Section: Discussionmentioning

confidence: 99%

Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register

et al. 2018

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“…Um estudo que avaliou a taxa de readmissão após a RLCA demonstrou que pacientes com mais de 40 anos foram readmitidos com mais frequência do que pacientes mais jovens, independentemente de outros fatores. (8) As cirurgias realizadas em caráter ambulatorial são benéficas em muitos aspectos, como a redução de custos (35) e a maior satisfação do paciente (36) comparado com o paciente operado em caráter hospitalar. Além disso, um estudo americano relatou que as taxas de readmissão hospitalar dentro de 90 dias após a RLCA foi significativamente maior entre pacientes que operaram em caráter hospitalar.…”

Section: Discussionunclassified

“…Estudo realizado nos Estados Unidos, avaliando apenas as reconstruções realizadas em regime hospitalar de 1998 a 2010, relatou que o tempo médio de internação foi 1,6 dias. (35) Outro estudo similar, porém com dados do sistema de saúde pública do Brasil, encontrou um tempo médio de internação de 1,8 dias em 2014. (41) Nesse mesmo estudo, os autores mostraram uma redução no tempo de internação ao longo dos anos.…”

Section: Discussionunclassified

“…Por causa dos benefícios e da segurança da RLCA realizada ambulatorialmente, a cirurgia realizada em regime hospitalar deve ser reservada para aqueles pacientes que por alguma razão, seja considerado inseguro receber alta no mesmo dia da cirurgia. (35) Foi observada nesse estudo uma alta preferência pelo uso do enxerto de TF. Nosso achado está de acordo com outros estudos que também relatam a atual preferência por este tipo de enxerto.…”

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Análise de 500 reconstruções do ligamento cruzado anterior de um registro institucional privado

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DedicatóriaA Deus, pois sem Ele, não teria forças para prosseguir com meus objetivos.Aos meus pais, Lauro e Mônica, pelo apoio incondicional durante toda a minha vida até aqui. Graças ao esforço deles tudo isso está sendo possível. À minha esposa, Natasha, por me apoiar em tudo o que faço. E pelo companheirismo e conselhos valiosos que me permitem caminhar com mais segurança.Ao meu orientador, Mário, por ter confiado em mim e me cedido essa grande oportunidade. Serei eternamente grato. À minha coorientadora, Eliane, pelas contribuições intelectuais durante o desenvolvimento dessa dissertação.Ao meu amigo, Noel, pela contribuição na pesquisa e pelas boas conversas que ajudaram a facilitar essa difícil jornada.

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Procedure length is independently associated with overnight hospital stay and 30-day readmission following anterior cruciate ligament reconstruction

Boddapati

Nwachukwu

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose was to characterize the independent effect of procedure length on the rates of 30‐day perioperative complications, hospital readmissions, and overnight hospital stay in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR). We hypothesized that longer procedure length in primary ACLR increases the risk for post‐operative complications. Methods Primary ACLR cases from 2005 to 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program registry. Patients were categorized into two cohorts based on procedure length, either less than or greater than 90 min. Two equal‐sized propensity‐matched cohorts were generated to account for differences in baseline and operative characteristics. Thirty‐day clinical outcomes were compared using bivariate analyses between propensity‐matched groups that controlled for patient‐specific factors and concurrent meniscal repair. Multivariate logistic regression models were used to identify independent predictors of hospital readmission and overnight hospital stay. Results In total, 12,077 ACLR cases were identified. The rate of any 30‐day complication was increased in longer procedures relative to shorter procedures (1.6% vs 0.9%, p = 0.006), as were the rates of returning to the operating room (0.6% vs 0.3%, p = 0.03), hospital readmission (1.0% vs 0.3%, p = 0.001), and overnight hospital stay (16.2% vs 6.0%, p < 0.001). Obesity was a risk factor for both hospital readmission and overnight hospital stay, while hypertension, diabetes, chronic obstructive pulmonary disease, and a smoking history were associated with increased rates of overnight hospital stay. The most common reasons for hospital readmission were deep vein thrombosis or pulmonary embolism (25.0% of all readmitted patients), surgical site infection (25.0%), and post‐operative pain (14.1%). Conclusions In this propensity‐matched analysis adjusting for baseline patient characteristics and operative factors, procedure length of greater than or equal to 90 min in ACLR was independently associated with an increased risk of hospital readmission and overnight hospital stay. As a surrogate measure of surgical complexity, operative time may be a useful perioperative variable for post‐operative risk stratification and patient counseling. Level of evidence III

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Inpatient Cruciate Ligament Reconstruction in the United States: A Nationwide Database Study From 1998 to 2010

Cited by 5 publications

References 12 publications

Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register

Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register

Análise de 500 reconstruções do ligamento cruzado anterior de um registro institucional privado

Procedure length is independently associated with overnight hospital stay and 30-day readmission following anterior cruciate ligament reconstruction

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