Hakan SOFU, İsmet Yalkın ÇAMURCU, Adem ÇÖBDEN, Utku DEMİR, Hanifi ÜÇPUNAR, Mehmet KIŞ, Hüseyin DEMİREL

TOTAL DİZ PROTEZİ SONRASI İLK 90 GÜN PLANSIZ YENİDEN BAŞVURUNUN TEMEL RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ

Amaç: Tek taraflı, eş zamanlı bilateral ya da aşamalı bilateral total diz protezi (TDP) uygulanan hastalarda ilk 90 gün plansız başvurunun temel belirleyici faktörlerini saptamaktır. Yöntemler: 2011-2016 yılları arasında TDP uygulanan hastaların verileri tıbbi kayıtlarımızdan değerlendirildi. Hastalar, tek taraflı, aşamalı bilateral ve eş zamanlı bilateral TDP grupları olarak üç gruba ayrıldı. Yaş, cinsiyet, vücut kitle indeksi (VKİ), sistemik komorbid hastalıklar ve Amerikan Anesteziyoloji Derneği (ASA) skorları, anestezi tekniği, toplam ameliyat süresi, traneksamik asit uygulaması, transfüze edilen toplam kan ünitesi ve hastanede yatış süresi tıbbi kayıtlardan araştırıldı. İlk 90 gün plansız ve planlı başvurusu olan hastaların verileri, t-testi, Pearson Ki-Kare testi ve Fisher's exact test ile karşılaştırıldı. Son olarak, ilk 90 gün plansız başvurunun temel belirleyici faktörlerini belirlemek için çok değişkenli analiz yapıldı. Bulgular: İlk 90 gün plansız başvurusu olan hastalarda toplam operasyon süresi, transfüze edilen toplam kan ünitesi ve hastanede yatış süresi anlamlı olarak daha yüksekti. İlk 90 gün plansız başvuru oranlarında TDP grupları arasında anlamlı bir fark gözlenmedi. Çok değişkenli lojistik regresyon analizine göre, hastanede kalış süresinin uzaması, 90 günlük plansız başvurunun ana belirleyicisi olarak belirlenmiştir. Sonuç: Bizim sonuçlarımıza göre, ilk 90 gün plansız başvuruda tek taraflı, eş zamanlı bilateral ve aşamalı bilateral TKA grupları arasında anlamlı bir fark gözlenmedi. Artmış hastanede yatış süresi, 90 günlük plansız başvurunun ana belirleyicisi olarak bulunmuştur.

Evaluation of Risk Factors For 90-Day Unplanned Readmissions After Total Knee Arthroplasty

Purpose: To determine the major predictive factors for 90-day unplanned readmission (UR) in patients whounderwent unilateral, simultaneous bilateral or staged bilateral total knee arthroplasty (TKA).Methods: The data of patients who underwent elective TKA between 2011 and 2016 were evaluated from ourmedical records. Patients were divided into three groups according to the type of TKA procedure as unilateral,staged bilateral and simultaneous bilateral TKA groups. Age, gender, body mass index (BMI), systemic comorbiddiseases, and American Society of Anesthesiologists (ASA) scores, anesthesia technique, total operation time,presence of tranexamic acid administration, total number of blood unit transfused ,and total length of hospitalstay were investigated through medical records. The data of patients with 90-day UR and no 90-day UR werecompared by student t-test, Pearson Chi-Square test, and Fisher’s exact test. Finally, multivariate analysis wasperformed to determine the major predictive factors of 90-day UR.Results: Total operative time, total amount of blood unit transfused, and total length of hospital stay weresignificantly higher in patients who had 90-day UR. No significant difference was observed among TKA groupsin 90-day UR rates. According to multivariate logistic regression analysis, increased total length of hospital staywas determined as the only major predictor of 90-day UR.Conclusion: According to our results, no significant difference was observed among unilateral, simultaneousbilateral and staged bilateral TKA groups in 90-day UR. The increased length of hospital stay was found as themajor predictor of 90-day UR.

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