Absence of combined effects of anemia and bilateral surgical status on inpatient rehabilitation outcomes following total knee arthroplasty.
OBJECTIVE
To examine the effects of anemia on inpatient rehabilitation outcomes following unilateral and bilateral total knee arthroplasty (TKA).


METHODS
This was a multicenter, retrospective study from 15 inpatient rehabilitation facilities. Patients (N = 5421) with very low hematocrit (Hct <30%), low Hct (30-36% women, 30-41% men), or normal Hct (>36% women, 41% men) were included. Inpatient rehabilitation occurred following TKA. Functional independence measure (FIM) scores, length of stay (LOS), itemized hospital charges, discharge destination were main outcomes.


RESULTS
LOS was 13% longer and hospital charges were 12.5-18.0% higher in the very low Hct than remaining groups (p = 0.0001). The FIM score and subscores for walking, stair climbing, bathing, transfers, and dressing changes were comparable for all Hct groups for the overall score. Hct <30% did not correspond to worse outcomes in patients with bilateral surgeries compared with unilateral surgeries; total FIM scores improved 47-53% across all Hct groups, regardless of bilateral surgical status. Discharge to home ranged 92.6-94.7% across all Hct groups (p > 0.05).


CONCLUSIONS
Rehabilitation teams can expect comparable functional improvements and discharge to home in anemic and non-anemic patients with either unilateral or bilateral surgeries without hematologic correction in the rehabilitation setting, but might need an additional day to accomplish these outcomes.
Vincent
Heather K
HK
Department of Orthopaedics and Rehabilitation, UF&Shands Orthopaedics and Sports Medicine Institute, University of Florida, PO Box 112727, Gainesville, FL 32611, USA. vincehk@ortho.ufl.edu
Omli
Morrow R
MR
Vincent
Kevin R
KR
D000203:Activities of Daily Living; D000368:Aged; D000704:Analysis of Variance; D000740:Anemia / Q000150:complications*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D017722:Hospital Charges; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome