Factors determining the burden for patients of south Indian population following total knee replacement in terms of hospital stay: A retrospective single center study

Abstract
Background: Total knee arthroplasty being the definite procedure in degenerative arthritis of the knee is associated with a high cost that includes the cost of implants & in-hospital length of stay (LOS). Incurring such high costs will put a burden on the patients economically, so the goal being the reduction of LOS yet improving the functional outcome with better patient satisfaction. The purpose of this study is to identify the perioperative risk factors increasing the LOS of patients, by quantifying them, efforts can be done to manage those risks providing better satisfaction to patients.Materials and Methods: The study design is a retrospective analysis of 1022 patients of primary elective total knee arthroplasty, performed in our institution. The potential factors recorded were: age, sex, hemoglobin levels, albumin levels, BMI calculated with patients height and weight, ASA grading, smoking alcohol status, diagnosis for which TKA was done and comorbids were analysedResults: We looked at 1022 patients and found the average length of stay is 6 days, with age, comorbids, BMI, ASA, Diagnosis, blood transfusion, hemoglobin and albumin all played a role to influence Length of stayConclusion: Our study showed that LOS after TKA is multifactorial. Various risk factors are present at the time of presentation, some of which are modifiable and some non-modifiable. It is important to acknowledge all the factors that increase the in-hospital LOS & to do one's uttermost use of medical resources.