To investigate the risk factors of delayed discharge after total hip arthroplasty(THA).

The patients who underwent elective unilateral THA in the First Affiliated Hospital of Chongqing Medical University from January 2017 to June 2020 were enrolled and reviewed, the patients with multiple injuries and pathologic fractures were excluded. The patients with postoperative length of stay more than six days were assigned to the delayed discharge group, and with postoperative length of stay less than six days assigned to the control group.The correlation between clinical data, including demographic characteristics, American Society of Anesthesiologists(ASA) grade, diagnosis, preoperative activity of mobility, preoperative length of stay, duration of operation, anesthesia techniques, intraoperative rehydration, intraoperative urine output, intraoperative blood loss, blood transfusion, complications, postoperative analgesia, Clavien-Dindo classification, visual analogue scale for 24 h after operation and mobilization time and delayed discharge was analyzed. Chi-square test was used for univariate analysis. Logistic regression analysis was used for multivariate analysis and to calculate odds ratios(OR) and 95% confidence intervals(CI).

Among the 756 cases, the median postoperatire hospital stay was six days, 420 cases in the delayed discharge group (55.6%), and 336 cases in the control group (44.4%). Age over 65 years[65 years to 79 years vs. age<65 years, OR=1.561, 95%CI(1.097, 2.222), P=0.013; age>79 years vs. age<65 years, OR=2.787, 95%CI(1.497, 5.186), P=0.001], hip fracture[OR=1.710, 95%CI(1.151, 2.540), P=0.008], preoperative hospital stay[4 d to 6 d vs. hospital stay<4 d, OR=2.024, 95%CI(1.027, 3.987), P=0.042; hospital stay>6 d vs. hospital stay<4 d, OR=3.821, 95%CI(1.766, 8.267), P=0.001], intraoperative blood loss>100 ml[OR=1.773, 95%CI(1.207, 2.604), P=0.004], Clavien-Dindo classification [level Ⅱ vs. under level Ⅰ, OR=2.437, 95%CI(1.730, 3.434), P<0.001; above level Ⅱ vs. levelⅠ, OR=7.157, 95%CI(1.581, 32.400), P=0.011], and mobilization>24 h[OR=1.683, 95%CI(1.206, 2.348), P=0.002] were independent risk factors for delayed discharge.

Age, hip fracture, preoperative hospital stay, intraoperative blood loss, Clavien-Dindo classification and postoperative mobilization were risk factors of delayed discharge after THA.These risk factors need to be intervened early to reduce the incidence of delayed discharge after THA.