The relationship between preoperative anemia and length of hospital stay among patients undergoing orthopedic surgery at a teaching hospital in Ethiopia: a retrospective cohort study.

Abstract

Introduction: Preoperative anemia in orthopedic surgery is linked to adverse outcomes such as longer hospital stays, higher rates of blood transfusion, and increased risk of death. Effectively addressing and managing this condition is essential for improving patient outcomes and shortening the length of hospital stays. In Ethiopia and other low-income countries, studies on preoperative anemia and its impact on the length of hospital stay following orthopedic surgery are limited. Therefore, this study aimed to assess the relationship between preoperative anemia and length of hospital stay among patients who underwent orthopedic surgery in Northwest Ethiopia.

Methods: A retrospective cohort study was conducted from June 01, 2019, to June 30, 2021, at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia. Data on demographic and clinical characteristics were collected using the Research Electronic Data Capture (REDCap) data collection system. Prolonged length of stay was defined as when a patient stays more than the 75th percentile of the LOS of all patients after orthopedic surgery. Multivariable logistic regression assessed the association between preoperative anemia and prolonged hospital stay length.

Results: Of 959 orthopedic patients enrolled in this study, 481 (50.16%) had preoperative anemia. The majority of patients underwent intramedullary nailing (27.63%) followed by debridement and irrigation (19.29%), and open reduction and internal fixation (17.00%) orthopedic procedures. The median length of hospital stays of all patients who underwent orthopedic surgery was 6 days (IQR 3, 13). During the follow-up, 212 patients had a prolonged length of stay following orthopedic surgery in the hospital. Of 212 patients who had prolonged hospital stays, 124 (58.49%) patients were anemic compared to 88 (41.51%) non-anemic patients. The odds of prolonged stay after orthopedic surgery were 1.77 (AOR = 1.77, 95% CI 1.25, 2.50) times higher among patients with preoperative anemia than those without preoperative anemia.

Conclusion: Preoperative anemia was independently associated with prolonged hospital stay among orthopedic surgery patients. Appropriate screening and treatment of preoperative anemia in orthopedic patients is essential.