A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program
Abstract Background The aim of this study was to identify the risk factors associated with prolonged length of stay (LOS) in patients undergoing primary total hip arthroplasty (THA) managed with an enhanced recovery after surgery (ERAS) program and develop a prediction model for improving the periop...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02877-6 |
| _version_ | 1828110097263362048 |
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| author | Haosheng Wang Tingting Fan Wenle Li Bo Yang Qiang Lin Mingyu Yang |
| author_facet | Haosheng Wang Tingting Fan Wenle Li Bo Yang Qiang Lin Mingyu Yang |
| author_sort | Haosheng Wang |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to identify the risk factors associated with prolonged length of stay (LOS) in patients undergoing primary total hip arthroplasty (THA) managed with an enhanced recovery after surgery (ERAS) program and develop a prediction model for improving the perioperative management of THA. Methods In this single-center retrospective study, patients who underwent primary THA in accordance with ERAS from May 2018 to December 2019 were enrolled in this study. The primary outcome was prolonged LOS (> 48 h) beyond the first postoperative day. We collected the clinical patient’s clinical characteristics, surgery-related parameters, and laboratory tests. A logistic regression analysis explored the independent risk factors for prolonged LOS. According to published literature and clinical experience, a series of variables were selected to develop a nomogram prediction model to predict the risk of prolonged LOS following primary THA with an ERAS program. Evaluation indicators of the prediction model, including the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, were reported to assess the performance of the prediction model. The bootstrap method was conducted to validate the performance of the designed nomogram. Results A total of 392 patients were included in the study, of whom 189 (48.21%) had prolonged LOS. The logistics regression analysis demonstrated that age, sex, hip deformities, intraoperative blood loss, operation time, postoperative Day 1 (POD) hemoglobin (Hb), POD albumin (ALB), and POD interleukin-6 (IL-6) were independent risk factors for prolonged LOS. The C-index was 0.863 (95% CI 0.808 to 0.918) and 0.845 in the bootstrapping validation, respectively. According to the results of the calibration, ROC curve, and decision curve analyses, we found that the nomogram showed satisfactory performance for prolonged LOS in this study. Conclusions We explored the risk factors for prolonged LOS following primary THA with an ERAS program and developed a prediction model. The designed nomogram was expected to be a precise and personalized tool for predicting the risk and prognosis for prolonged LOS following primary THA with an ERAS program. |
| first_indexed | 2024-04-11T11:13:12Z |
| format | Article |
| id | doaj.art-c4abe48be5d442a6b444f83d4f079a80 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T11:13:12Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-c4abe48be5d442a6b444f83d4f079a802022-12-22T04:27:19ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-12-0116111010.1186/s13018-021-02877-6A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery programHaosheng Wang0Tingting Fan1Wenle Li2Bo Yang3Qiang Lin4Mingyu Yang5Department of Orthopedics, Taizhou Central Hospital (Affiliated Hospital To Taizhou College)Department of Endocrinology, Baoji City Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Xianyang Central HospitalDepartment of Orthopedics, Baoji City Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Baoji City Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Taizhou Central Hospital (Affiliated Hospital To Taizhou College)Abstract Background The aim of this study was to identify the risk factors associated with prolonged length of stay (LOS) in patients undergoing primary total hip arthroplasty (THA) managed with an enhanced recovery after surgery (ERAS) program and develop a prediction model for improving the perioperative management of THA. Methods In this single-center retrospective study, patients who underwent primary THA in accordance with ERAS from May 2018 to December 2019 were enrolled in this study. The primary outcome was prolonged LOS (> 48 h) beyond the first postoperative day. We collected the clinical patient’s clinical characteristics, surgery-related parameters, and laboratory tests. A logistic regression analysis explored the independent risk factors for prolonged LOS. According to published literature and clinical experience, a series of variables were selected to develop a nomogram prediction model to predict the risk of prolonged LOS following primary THA with an ERAS program. Evaluation indicators of the prediction model, including the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, were reported to assess the performance of the prediction model. The bootstrap method was conducted to validate the performance of the designed nomogram. Results A total of 392 patients were included in the study, of whom 189 (48.21%) had prolonged LOS. The logistics regression analysis demonstrated that age, sex, hip deformities, intraoperative blood loss, operation time, postoperative Day 1 (POD) hemoglobin (Hb), POD albumin (ALB), and POD interleukin-6 (IL-6) were independent risk factors for prolonged LOS. The C-index was 0.863 (95% CI 0.808 to 0.918) and 0.845 in the bootstrapping validation, respectively. According to the results of the calibration, ROC curve, and decision curve analyses, we found that the nomogram showed satisfactory performance for prolonged LOS in this study. Conclusions We explored the risk factors for prolonged LOS following primary THA with an ERAS program and developed a prediction model. The designed nomogram was expected to be a precise and personalized tool for predicting the risk and prognosis for prolonged LOS following primary THA with an ERAS program.https://doi.org/10.1186/s13018-021-02877-6Total hip arthroplastyLength of stayEnhanced recovery after surgeryRisk factorsNomogram |
| spellingShingle | Haosheng Wang Tingting Fan Wenle Li Bo Yang Qiang Lin Mingyu Yang A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program Journal of Orthopaedic Surgery and Research Total hip arthroplasty Length of stay Enhanced recovery after surgery Risk factors Nomogram |
| title | A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program |
| title_full | A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program |
| title_fullStr | A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program |
| title_full_unstemmed | A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program |
| title_short | A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program |
| title_sort | nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program |
| topic | Total hip arthroplasty Length of stay Enhanced recovery after surgery Risk factors Nomogram |
| url | https://doi.org/10.1186/s13018-021-02877-6 |
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