Does the Timed-Up-and-Go Test Predict Length of Stay After Total Hip Arthroplasty? A Retrospective Study

Marissa Guttenberg, Gabriella Argento, Danielle McInerney, Joseph Nguyen, Olivia Wuest
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Abstract

The prevalence of ambulatory total hip arthroplasty (THA) is rising, but it is not appropriate for all patients. Preoperative patient selection considers medical and social factors but overlooks patients’ prior level of physical function. The aim of this study was to evaluate if preoperative physical function, measured by the Timed-Up-and-Go (TUG) test, is associated with length of stay (LOS) in patients who underwent primary THA. A retrospective study was performed using 396 patients who underwent primary THA within a 2-month period at a single institution. Regression analysis evaluated the relationship between preoperative TUG scores and hospital LOS. Receiver-operating characteristic (ROC) curves were generated to identify a cutoff TUG score associated with LOS longer than 24 hours. Univariate regression analysis of those discharged in less than 24 hours and those discharged in more than 24 hours found lower TUG scores (10.7 vs 13.7, respectively) were associated with patient discharge within 24 hours. Multivariate regression analysis showed a higher TUG score (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.84-0.99) was associated with decreased odds of discharge within 24 hours. Receiver-operating characteristic curve analysis was performed on the entire study cohort and the ambulatory surgery group and identified TUG scores of 10.3 and 10.5 seconds, respectively, associated with LOS of less than 24 hours (OR full cohort: 3.02, 95% CI: 1.94-4.71; OR ambulatory surgery: 2.97, 95% CI: 1.90-4.60). Sensitivity and specificity were not sufficient to support the use of these cutoff scores alone in predicting LOS. Although we were unable to establish a cutoff TUG score in patients who underwent primary THA that could determine LOS of more than 24 hours, the preoperative TUG score may be useful as a tool to aid in identifying patients who may require a longer hospital LOS. Further study is needed.
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定时起立行走试验能否预测全髋关节置换术后的住院时间?回顾性研究
非卧床全髋关节置换术(THA)的发病率正在上升,但并非所有患者都适合这种手术。术前患者选择考虑了医疗和社会因素,但忽略了患者之前的身体功能水平。本研究旨在评估通过定时起立行走(TUG)测试测量的术前身体功能是否与接受初次 THA 患者的住院时间(LOS)相关。一项回顾性研究使用了一家医疗机构两个月内接受初级 THA 手术的 396 名患者。回归分析评估了术前 TUG 评分与住院时间之间的关系。生成了接收者操作特征曲线(ROC),以确定与住院时间超过 24 小时相关的 TUG 评分临界值。对出院时间少于 24 小时和超过 24 小时的患者进行单变量回归分析后发现,较低的 TUG 分数(分别为 10.7 分和 13.7 分)与患者在 24 小时内出院有关。多变量回归分析显示,TUG 分数越高(调整后的几率比 [aOR]:0.91,95% 置信区间 [CI]:0.84-0.99),患者在 24 小时内出院的几率越小。对整个研究队列和非卧床手术组进行了接收者工作特征曲线分析,发现TUG评分分别为10.3秒和10.5秒与24小时以内的LOS有关(整个队列的OR:3.02,95% CI:1.94-4.71;非卧床手术的OR:2.97,95% CI:1.90-4.60)。灵敏度和特异性不足以单独支持使用这些临界值来预测 LOS。虽然我们无法为接受初级 THA 的患者确定一个可确定 LOS 超过 24 小时的 TUG 临界评分,但术前 TUG 评分作为一种工具可能有助于识别可能需要较长住院 LOS 的患者。还需要进一步研究。
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