Abstract
Introduction: Hypothesis: Patients undergoing operations at the end of the week are disadvantaged by the lack of weekend physiotherapy. Aim: To test the hypothesis by review of a single surgeon series of patients identifying factors affecting the post-operative length of stay
Methods: A cohort of patients with OA undergoing elective primary joint replacement was identified. Data was collected for demographics, procedures undertaken and length of stay.
Results: 42 patients were included in the cohort. There were 23 hip and 19 knee replacements with an average age of 73.47 years. Multivariate analysis of the data was performed to ensure that the age, pathology, ASA and days of the week were equally represented. Further analysis revealed that the main factor contributing to length of stay was the age of the patient (5.13 days if age< 75 vs. 6.33 days if olderthan 75 years). Patients having surgery at the end of the week actually had a reduced length of stay compared to those at the start of the week (5.27 vs. 6.22 days).
Discussion: The day of surgery does have effect on the length of stay post op. The widespread assumption that weekend physio to mobilise patients early post op may not be well founded. It is more likely that targetting patients to encourage discharge would be a more effective use of resource.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
