Factors Associated with a Prolonged Hospital Stay Following Total Knee Arthroplasty in a Community Hospital: A Retrospective Cohort Study

Abstract

Purposes: To investigate risk factors associated with prolonged hospital length of stay following total knee arthroplasty in a community hospital.

Study design: A Retrospective Cohort Study.

Materials and Methods: This retrospective cohort study reviewed medical records of 97 patients who underwent unilateral TKA performed by a single surgeon at Suwannaphum Hospital between January 2023 and December 2024. Patients were categorized into prolonged LOS (>3 days) and standard LOS (≤3 days). Variables with p < .20 in univariate chi-square analyses were included in a multiple logistic regression with backward elimination. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, with significance defined at p < .05.

 Main finding : Multivariable analysis identified three significant predictors of prolonged LOS: female (aOR = 6.25; 95% CI: 2.11, 8.87; p = 0.003), wound dehiscence (aOR = 13.86; 95% CI: 3.05, 62.96; p = .001), and spinal block anesthesia (aOR = 4.71; 95% CI: 1.79, 12.39; p = .002).

Conclusion and recommendations: Female, wound dehiscence, and spinal block anesthesia were independent risk factors for prolonged LOS after TKA in a community hospital. Proactive perioperative management particularly enhanced wound care and individualized anesthesia planning may shorten LOS and improve efficiency of care delivery.