Hospital Length of Stay Is Associated With Increased Likelihood for Venous Thromboembolism After Total Joint Arthroplasty

Brett Salomon; Vinod Dasa; Peter C Krause; Lauren Hall; Andrew G Chapple

doi:10.1016/j.artd.2020.12.025

Hospital Length of Stay Is Associated With Increased Likelihood for Venous Thromboembolism After Total Joint Arthroplasty

Arthroplast Today. 2021 Feb 24:8:254-257.e1. doi: 10.1016/j.artd.2020.12.025. eCollection 2021 Apr.

Authors

Brett Salomon¹, Vinod Dasa², Peter C Krause², Lauren Hall³, Andrew G Chapple⁴

Affiliations

¹ LSU HSC NO School of Medicine, New Orleans, LA, USA.
² LSU HSC NO Department of Orthopaedics, New Orleans, LA, USA.
³ Baylor Scott and White Research Institute, Dallas, TX, USA.
⁴ LSU HSC NO Department of Public Health and Biostatistics, New Orleans, LA, USA.

Abstract

Background: The prevalence of venous thromboembolism (VTE) after total joint arthroplasty (TJA) is 0.40%-1.2%. Trends in TJA are for shorter hospital stays with lower complication rates. The aim of this study is to evaluate whether hospital length of stay (LOS) is associated with risk of a thromboembolic event after TJA.

Methods: This was a retrospective study of patients undergoing TJA during 2013-2017 at Louisiana and Texas hospitals. Univariable analyses and multivariable logistic regression examined patient characteristics (sex, race, age, body mass index, Charlson Comorbidity Index, TJA type, and LOS) associated with experiencing a VTE event after discharge and before 1-year follow-up.

Results: Of the 13,969 patients who met inclusion criteria, 338 (2.4%) had a VTE event after discharge. In multivariable regression analysis, more severe comorbidities (odds ratio: 1.30, 95% confidence interval: 1.23-1.37; P < .001) and LOS days (odds ratio: 1.07, 95% confidence interval: 1.01 to 1.14; P = .0215) were associated with an increased risk of VTE.

Conclusion: Patients with more severe comorbidities or a longer LOS had a greater risk of VTE after discharge following TJA.

Keywords: Complications; Deep vein thrombosis; Total hip arthroplasty; Total knee arthroplasty; Venous thrombotic event.