| Objective With the arrival of an aging society, the incidence of postmenopausal femoral neck fractures is increasing. This study focused on retrospective analysis of the general conditions, comorbidities and perioperative factors of these patients undergoing total hip arthroplasty (THA). Understanding the correlation between these factors and postoperative hospital stay (LOS) can provide some reference for future treatment plan structured intervention and process improvement. Methods The medical records of postmenopausal patients with femoral neck fractures who received THA in the Second Affiliated Hospital of Soochow Universityfrom January 2015 to December 2019 were retrospectively analyzed. A total of 637 patients were included, with an average age of 70.6±6.5 years, an average BMI of 28.2±5.7 kg/m2, a median LOS of 7 (6,8) days, and 263 patients (41.3%) with a LOS longer than the median; Logistic regression method was used to analyze the related factors affecting LOS. Results ①Univariate analysis was used to analyze the LOS factors affecting THA, including age, BMI, admission time, ASA (American Society of Anesthesiologists) classification, comorbidities, preoperative waiting time, operation time, anemia, postoperative hypoalbuminemia. The 10 indexes of symptoms and postoperative adverse events were statistically significant (P<0.05). ②The factors of P<0.1 were included in the binary logistic regression model for multivariate analysis, in which age > 70 years old (OR: 1.513; 95% CI: 1.032-2.260; P<0.001), BMI<18.5 kg/m2(OR: 1.577; 95% CI: 1.073-2.319; P=0.021), admission on Friday or Saturday (OR: 1.558; 95% CI:1.154-2.412; P=0.007), ASA III/IV (OR: 2.076; 95% CI: 1.472- 2.926; P<0.001), combined with preoperative anemia (OR: 1.665; 95% CI: 1.338-2.072;P<0.001), combined with postoperative adverse events (OR: 1.814; 95% CI: 1.174-2.803; P=0.007) Six indicators were independent risk factors for prolonged LOS. Conclusion The length of postoperative hospital stay (LOS) is closely related to the postoperative recovery status of the elderly. The prolonged LOS after THA in postmenopausal femoral neck fracture patients is related to some demographics, comorbidities, perioperative indicators, admission time and other factors. Six indicators are independent risk factors; therefore, understanding these independent risk factors, improving the level of individualized intervention as much as possible, and improving the perioperative process in a differentiated manner will be very beneficial to shorten the LOS after THA in patients with postmenopausal femoral neck fractures. |