A patient's perception of their hospital stay influences the functional outcome and satisfaction of total knee arthroplasty.
BACKGROUND
To assess whether patient satisfaction with their hospital stay influences the early outcome of total knee arthroplasty (TKA).


METHODS
During a 5-year period patients undergoing primary TKA at the study centre had prospective outcome data recorded (n = 2264). The Oxford knee score (OKS) and the short form (SF)-12 were recorded pre-operatively and 1 year post-operatively when satisfaction with their TKA was also assessed. Patient satisfaction with their hospital stay was also evaluated and their reasons for it were qualitatively documented.


RESULTS
Decreasing level of satisfaction with their hospital stay was associated with a significantly worse post-operative OKS (p < 0.001) and SF-12 score (p < 0.001). Multivariable regression analysis confirmed that the patient's perceived level of satisfaction with their hospital stay was an independent predictor of change in the OKS (p < 0.001) and SF-12 score (p < 0.006) after adjusting for confounding variables. Patient satisfaction with their TKA was significantly influenced by their hospital experience, decreasing from 96% in those with an excellent experience to 42% in those with a poor experience. Food, staff/care, and the hospital environment were the most frequent reasons of why patients rated their hospital experience as fair or poor.


CONCLUSIONS
A patient's perception of their inpatient hospital experience after surgery is an important modifiable predictor of early functional outcome and satisfaction with TKA.
Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK. nickclement@doctors.org.uk.
N D
ND
Clement
University of Edinburgh, Little France, Edinburgh, EH16 4SB, UK.
D
D
Macdonald
Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK.
R
R
Burnett
Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK.|University of Edinburgh, Little France, Edinburgh, EH16 4SB, UK.
A H R W
AHRW
Simpson
Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK.
C R
CR
Howie
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function
Experience; Hospital; Outcome; Satisfaction; Stay; Total knee arthroplasty