Abstract
Abstract. Introduction The Covid-19 pandemic has led to quite significant changes in the length of hospital stay of orthopedic patients. Meanwhile, there has been a tendency for early discharge after arthroplasty for quite some time due to the increasing burden on health care systems that became possible due to the implementation of accelerated rehabilitation protocols. This study is dedicated to the effect of discharge terms on the incidence of postoperative complications. Material and methods A retrospective study of 1,837 patients who underwent primary/revision THA and TKA at our center in 2020 was carried out. The impact of the pandemic was assessed by comparing the duration of hospitalization, the incidence of complications and functional status in patients operated on before and after the introduction of epidemiological restrictions. Purpose of the study To assess the impact of the Covid-19 pandemic on the length of patients’ hospital stay after knee and hip arthroplasty. Results The total duration of hospitalization after primary THA was reduced by 35 % (from 11.8 ± 3.3 to 7.7 ± 2.6 bed-days), and by 38 % (from 19.9 ± 7.5 to 12.8 ± 6.3 bed-days) after revision THA. The overall readmission rate (for surgical and nonsurgical complications) after primary THA was 4.1 % before the pandemic and 4.3 % during the pandemic; for primary TKA it was 2.1 % and 5.1 %, respectively; for revision THA – 13.9 % and 4.5 %, revision TKA – 4.4 % and 9.8 %, respectively. Comparative assessment for each diagnosis separately did not show significant difference. Evaluation of the questionnaire survey using the Oxford hip/knee score also showed the absence of a statistically significant relationship between the time of discharge and the functional state of the operated joint. The interviewing of patients regarding the infection with coronavirus yielded positive answers in 22 % (n = 419). The onset of symptoms during hospitalization or within 14 days after discharge was noted by 4 % of respondents (n = 75). Conclusion The incidence of complications and unfavorable outcomes did not depend on the length of hospital stay after THA and TKA.
Highlights
Introduction The Covid19 pandemic has led to quite significant changes in the length of hospital stay of orthopedic patients
Spence et al we studied the mortality rate from postoperative complications in a prospective randomized study of 40,004 patients who underwent emergency and elective interventions in 28 hospitals from 14 countries
Patients who were in quarantine in April 2020 and had an extremely long duration of hospital stay; they were excluded from the comparative assessment of hospital stay and impact on postoperative complications
Summary
19 pandemic has led to quite significant changes in the length of hospital stay of orthopedic patients. The impact of the pandemic was assessed by comparing the duration of hospitalization, the incidence of complications and functional status in patients operated on before and after the introduction of epidemiological restrictions. Purpose of the study To assess the impact of the Covid-19 pandemic on the length of patients’ hospital stay after knee and hip arthroplasty. In many countries, during the peak of the first wave of the pandemic (March, April 2020), planned operations were suspended due to the re-profiling of hospitals, as well as to protect patients and staff from asymptomatic and undiagnosed carriers [1, 2]. The imposed sanitary and epidemiological restrictions in hospitals could not properly prevent the spread of viral pneumonia, and led to the need to reduce the duration of patients' stay in hospitals [7, 8]
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