Predictors of Hospital Length of Stay among Patients after Hip Arthroplasty

Main Article Content

Aemwika Suksatit
Suporn Danaidutsadeekul
Orapan Thosingha
Kongkhet Riansuwan


Purpose: To study the patient's hospital length of stay after hip arthroplasty and to examine the predictive power of body mass index, alcohol consumption and recovery of physical function on the hospital length of stay.

Design: Correlational predictive study design.

Methods: The sample group consisted of 120 patients after hip arthroplasty at four tertiary care hospitals in Bangkok. Data were collected from May 2020 – November 2020 using the Alcohol Use Disorder Identification Test and the Cumulated Ambulation Score. Statistical analysis was performed using descriptive statistics, Pearson’s product moment correlation, and multiple regression.

Main findings: The findings showed that 76.7% were female with a mean age of 70.40 years (SD = 14.17), a mean body mass index of 21.67 kg/m2 (SD = 2.53), low risk level of alcohol drinking (gif.latex?\bar{X} = 3, SD = 3.80), good physical functioning recovery (gif.latex?\bar{X} = 4.88, SD = 1.28), and a mean of hospital length of stay of 6.59 days (SD = 1.90). Alcohol drinking (gif.latex?\beta = .28, p < .01), the body mass index (gif.latex?\beta = - .20, p < .05), and physical functioning recovery (gif.latex?\beta = - .25, p < .01) could significantly predict hospital length of stay of the patients; the variance was explained 19% by all factors (R2 = .19).

Conclusion and recommendations:  Body mass index, alcohol drinking and physical functioning recovery can affect the hospital length of stay among the patients after hip arthroplasty. The research findings guide nursing practice by promoting appropriate body mass index, discouraging the alcohol drinking, and promoting activities that help recovery of patients after hip arthroplasty to reduce complications from long hospitalization resulting in the reduced hospital length of stay.

Article Details

How to Cite
Suksatit, A., Danaidutsadeekul, S. ., Thosingha, O. ., & Riansuwan, K. . (2022). Predictors of Hospital Length of Stay among Patients after Hip Arthroplasty. Nursing Science Journal of Thailand, 40(4), 110–122. Retrieved from
Research Papers


Panteli M, Habeeb S, McRoberts J, Porteous MJ. Enhanced care for primary hip arthroplasty: factors affecting length of hospital stay. Eur J Trauma Emerg Surg. 2014;24(3):353-8. doi: 10.1007/s00590-013-1188-z.

Sloan M, Premkumar A, Sheth NP. Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am. 2018;100(17):1455-60. doi: 10.2106/JBJS.17.01617.

Tan STS, Tan WPM, Jaipaul J, Chan SP, Sathappan SS. Clinical outcomes and hospital length of stay in 2,756 elderly patients with hip fractures: a comparison of surgical and non-surgical management. Singapore Med J. 2017;58(5):253-7. doi: 10.11622/smedj.2016045.

Miller LE, Gondusky JS, Bhattacharyya S, Kamath AF, Boettner F, Wright J. Does surgical approach affect outcomes in total hip arthroplasty through 90 days of follow-up? A systematic review with meta-analysis. J Arthroplasty. 2018;33(4):1296-302. doi: 10.1016/j.arth.2017.11.011.

Muhm M, Klein D, Weiss C, Ruffing T, Winkler H. Mortality after proximal femur fracture with a delay of surgery of more than 48 h. Eur J Trauma Emerg Surg. 2014;40(2):201-12. doi: 10.1007/s00068-013-0368-1.

Mine Y, Fujino Y, Sabanai K, Muramatsu K, Otani M, Kubo T, et al. Effectiveness of regional clinical pathways on postoperative length of stay for hip fracture patients: a retrospective observational study using the Japanese diagnosis procedure combination database. J Orthop Sci. 2020;25(1):127-31. doi: 10.1016/j.jos.2019.02.002.

Elings J, Hoogeboom TJ, van der Sluis G, van Meeteren NLU. What preoperative patient-related factors predict inpatient recovery of physical functioning and length of stay after total hip arthroplasty? A systematic review. Clin Rehabil. 2015;29(5):477-92. doi: 10.1177/0269215514545349.

Burn E, Edwards CJ, Murray DW, Silman A, Cooper C, Arden NK, et al. Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement: evidence from linked primary care and NHS hospital records from 1997 to 2014. BMJ Open. 2018;8(1):e019146. doi: 10.1136/bmjopen-2017-019146.

Dlamini NF, Ryan PV, Moodley Y. Incidence and risk factors for extended post-operative length of stay following primary hip arthroplasty in a South African setting. SA Orthopedic Journal. 2019;18(1):40-6. doi: 10.17159/2309-8309/2019/v18n1a5.

Kremers HM, Visscher SL, Kremers WK, Naessens JM, Lewallen DG. Obesity increases length of stay and direct medical costs in total hip arthroplasty. Clin Orthop Relat Res. 2014;472(4):1232-9. doi: 10.1007/s11999-013-3316-9.

Matthew B, Brian G. Response to: comment on Intra-articular hip injections for lateral hip pain. J Hip Preserv Surg. 2015;2(1):81. doi: 10.1093/jhps/hnv014.

Klaewklong S, Chanruangvanich W, Danaidutsadeekul S, Rainsuwan K. Relation of comorbidity, grip strength and stress to hip fracture patients’ post-operative functional recovery. Thai Journal of Nursing Council. 2014;29(2):36-48. (in Thai).

Barone SH, Roy CL, Frederickson KC. Instruments used in Roy adaptation model-based research: review, critique, and future directions. Nurs Sci Q. 2008;21(4):353-62. doi: 10.1177/0894318408323491.

Faul F, Erdfelder E, Buchner A, Lang A-GJBrm. Statistical power analyses using G*power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-60. doi: 10.3758/BRM.41.4.1149.

Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 8th ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008. 796 p.

Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT: The alcohol use disorders identification test: guidelines for use in primary health care. 2nd ed. Geneva: World Health Organization; 2001. 39 p.

Kristensen MT, Bandholm T, Foss NB, Ekdahl C, Kehlet H. High inter-tester reliability of the new mobility score in patients with hip fracture. J Rehabil Med. 2008;40(7):589-91. doi: 10.2340/16501977-0217.

Kristensen MT, Kehlet H. The basic mobility status upon acute hospital discharge is an independent risk factor for mortality up to 5 years after hip fracture surgery. Acta Orthop. 2018;89(1):47-52. doi: 10.1080/17453674.2017.1382038.

Hernigou P, Auregan JC, Potage D, Roubineau F, Lachaniette CHF, Dubory AJIo. Dual-mobility implants prevent hip dislocation following hip revision in obese patients. Int Orthop. 2017;41(3):469-73. doi: 10.1007/s00264-016-3316-y.

An R, Andrade F, Chiu C-YJPmr. Overweight and obesity among US adults with and without disability, 1999–2012. Prev Med Rep. 2015;2:419-22. doi: 10.1016/j.pmedr.2015.05.001.

Sayed-Noor AS, Mukka S, Mohaddes M, Kärrholm J, Rolfson OJAo. Body mass index is associated with risk of reoperation and revision after primary total hip arthroplasty: a study of the Swedish Hip Arthroplasty Register including 83,146 patients. Acta Orthop. 2019;90(3):220-5. doi:10.1080/17453674.2019.1594015.

Traversy G, Chaput J-PJCor. Alcohol consumption and obesity: an update. 2015;4(1):122-30. Curr Obes Rep. doi: 10.1007/s13679-014-0129-4.

Rotevatn TA, Boggild H, Olesen CR, Torp-Pedersen C, Mortensen RN, Jensen PF, et al. Alcohol consumption and the risk of postoperative mortality and morbidity after primary hip or knee arthroplasty–A register-based cohort study. 2017;12(3):e0173083. PLoS ONE. doi: 10.1371/journal.pone.0173083.

Singpunya M, Thosingha O, Danaidutsadeekul S, Rainsuwan K. Factor predicting functional recovery of patients undergoing hip arthroplasty. Thai Journal of Cardio-Thoracic Nursing. 2017;28(1):154-67. (in Thai).

Deelertmongkolkul W, Danaidutsadeekul S, Chanruangvanich W, Udomkiat P. The relationship between body mass index, pain, social support and the activity daily living during recovery phase in hip arthroplasty patients. Nursing Science Journal of Thailand. 2013;31(2):26-37. (in Thai).