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Knee Surg Relat Res. 2018 Mar;30(1):50-57. English. Original Article. https://doi.org/10.5792/ksrr.17.079
Rudasill S , Dattilo JR , Liu J , Clements A , Nelson CL , Kamath AF .
David Geffen School of Medicine, Los Angeles, CA, USA. srudasill@ucla.edu
Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Department of Anesthesiology, University of Pennsylvania, Philadelphia, PA, USA.
University of Pennsylvania, Philadelphia, PA, USA.
Abstract

Purpose

Total knee arthroplasty (TKA) is increasing in frequency and cost. Optimization of discharge location may reduce total expenditure while maximizing patient outcomes. Although preoperative illness rating systems—including the American Society for Anesthesiologists Physical Classification System (ASA), severity of illness scoring system (SOI), and Mallampati rating scale (MP)—are associated with patient morbidity and mortality, their predictive value for discharge location, length of stay (LOS), and total costs remains unclear.

Materials and Methods

We conducted a retrospective analysis of 677 TKA patients (550 primary and 127 revision) treated at a single institution. The influence of ASA, SOI, and MP scores on discharge locations, LOS, and total costs was assessed using multivariable regression analyses.

Results

None of the systems were significant predictors of discharge location following TKA. SOI scores of major or higher (β=2.08 days, p < 0.001) and minor (β=−0.25 days, p=0.009) significantly predicted LOS relative to moderate scores. Total costs were also significantly predicted by SOI scores of major or higher (β=$6,155, p=0.022) and minor (β=−$1,163, p=0.007).

Conclusions

SOI scores may be harnessed as a predictive tool for LOS and total costs following TKA, but other mechanisms are necessary to predict discharge location.

Copyright © 2019. Korean Association of Medical Journal Editors.