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http://hdl.handle.net/11434/1292
Title: | Can we predict length of stay in orthopaedic rehabilitation? |
Epworth Authors: | Thanarajah, Premini Hale, Thomas McKenzie, Dean Olver, John |
Keywords: | Joint Replacements Neck of Femur NOF Rates of Fractures Rehabilitation Pain at Rest Pain on Movement Hip Replacement Knee Replacement Functional Idependence Measure FIM Length of Stay LOS Least Absolute Shrinkage and Selection Operator LASSO Rehabilitation, Mental Health and Chronic Pain Clinical Institute, Epworth HealthCare, Victoria, Australia Epworth Monash Rehabilitation Unit (EMReM), Epworth HealthCare, Richmond, Victoria, Australia. |
Issue Date: | 2018 |
Publisher: | Bio Accent |
Citation: | BAOJ Ortho. 2018; 3(1): 019 |
Abstract: | OBJECTIVES: Rates of Joint Replacements and Neck of Femur (NOF) fractures are rapidly increasing due to an ageing population, thus placing an increasing demand on Rehabilitation Services. METHOD: We conducted this retrospective study to investigate how pain at rest and on movement (documented on admission), type of operation (hip/ knee replacement vs neck of femur fracture), age, gender and admission Functional Independence Measure (FIM) total score impacted on Length of Stay (LOS). The cohort comprised all consecutive patients admitted to a Victorian Rehabilitation Hospital post Fractured NOF, Elective Total Hip and Total Knee Replacement surgery from 6 February 2012 – 6 June 2012. The sample comprised 63 patients, predominantly female (54 or 85.7%), aged from 48-96 years (mean=74, sd=11.1). LOS ranged from 2-49 days (mean=17.2, sd=9.5). Multiple regression examined all 6 variables simultaneously. A contemporary variable selection method, known as LASSO regression, searched for key variables by attempting to shrink less important regression coefficients towards zero. The main outcome measure in this study length of stay. No interventions were used in this study. RESULTS: The full regression model of 6 variables accounted for 65.3% variation in LOS, however, LASSO regression selected 3 variables which accounted for 62.9% of variation in LOS, there being no statistically significant loss of performance with the smaller model. The 3 variables were admission FIM, operation type, and pain on movement. Increased admission FIM and knee or hip replacement were associated with shorter LOS, Neck of Femur fracture and increased pain on movement were associated with longer LOS. CONCLUSION: Given the increased demand on rehabilitation beds, predicting length of stay using the 3 key markers identified in this study may help to optimise resource allocation. |
URI: | http://hdl.handle.net/11434/1292 |
URL: | https://bioaccent.org/orthopaedics/orthopaedics19.pdf |
Journal Title: | BAOJ Orthopedics |
Type: | Journal Article |
Affiliated Organisations: | Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria |
Type of Clinical Study or Trial: | Retrospective studies |
Appears in Collections: | Rehabilitation |
Files in This Item:
File | Description | Size | Format | |
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Thanarajah et al 2018.pdf | 283.04 kB | Adobe PDF | View/Open |
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