Predictive Factors for Length of Hospital Stay after Primary Total Hip Replacement in an Asian Joint Replacement Center

Introduction:The continuously expanding aging population in Hong Kong is expected to have a tremendous increase in demand for joint replacement service in the coming 20 years.There are various existing overseas studies on prediction of length of stay (LOS) after total hip replacement (THR) on western demographics.However, the length of stay and cultural background of Caucasian population are significantly different from local data.There is a knowledge gap for a local study to determine the factors of the Hong Kong population.Also, shortening hospital stay helps minimize the associated medical cost.Hence, the objective of this study is to identify various predictors for length of hospital stay following primary total hip replacement performed at a joint center in Hong Kong.Method: All primary total hip replacements performed from 1/1/2018 to 30/6/2023 at Tseung Kwan O Hospital Joint Replacement Center were retrospectively reviewed.A number of postulated factors, ranging from patient, surgical to post-operative variables which were suggested to lengthen the hospital stay, were collected and analyzed.Result: A total of 100 patients, out of 106 retrieved, were included in this study.The mean length of hospital stay was 15.4 days, which was distinctive from figures in overseas studies.Predictors of prolonged hospital stay included advanced age, post-operative intensive care unit care and a pre-operative low Risk Assessment Prediction Tool (RAPT) score. Conclusion:By defining the associated factors of prolonged hospital stay, physicians should be able to improve the current practice in joint replacement surgery.Stratifying the high-risk group of patients pre-operatively empowers clinicians for better anticipation and customizing discharge arrangement.