Length of hospital stay after total knee arthroplasty among obese patients: A single-center study

Knee osteoarthritis (OA) accounts for almost 80% of the worldwide burden of OA, with a pooled global prevalence of 22.9% (95% CI, 19.8-26.1%) in individuals aged 40 years and older. Total knee arthroplasty (TKA) is a highly effective procedure for treating knee OA. The length of stay (LOS) after TKA is an important measure of care quality, and predicting it can assist in optimizing patient recovery and healthcare strategies. This study aimed to evaluate the LOS and re-admission rates following TKA at Prince Metaab Bin Abdulaziz Hospital in Saudi Arabia. This retrospective, observational, analytical study included 194 patients who underwent primary TKA at Prince Metaab Bin Abdulaziz Hospital from January 2019 to June 2024. Data were collected from electronic health records and included demographics, LOS, mobility, blood transfusions, re-admissions, ASA grade, and postoperative complications. A negative binomial regression model was used to identify the factors associated with LOS. Statistical analysis was performed using SPSS version 27, with a P-value of < .05 considered significant. The median age of the patients was 63 years. Most patients were females (77%), while 72% and 26% were obese and overweight, respectively, and 15% were smokers. The median LOS was 4 days, and 47.4% of the patients stayed for 4-6 days. Re-admission occurred in 6.7% of cases, and the most common reasons being infection, joint pain, and knee stiffness. Postoperative complications occurred in 10% of the patients. A stepwise negative binomial regression model revealed that postoperative mobility (Exp(B) = 0.578, P < .001) was associated with shorter LOS, and ASA grade 2 patients were more likely to have a shorter LOS than ASA grade 3 patients (Exp(B) = 0. 749, P = .002). Dyslipidemia (Exp(B) = 1.522, P < .001) and smoking history (Exp(B) = 1.407, P < .001) were associated with a longer LOS. This study identified postoperative mobility, dyslipidemia, ASA grade, and smoking history as factors influencing the LOS after TKA. Improving early mobilization and managing comorbidities, such as dyslipidemia and smoking, may reduce LOS, enhance patient outcomes, and reduce healthcare costs.