Risks of Increased Operative Time and Longer Hospital Stays Based on Age in Total Ankle Arthroplasty

Abstract

Background As total ankle arthroplasty (TAA) is increasingly performed in younger individuals in the United States, the aim of this study was to analyze TAA outcomes and complications by age. Methods A total of 1619 primary and revision TAAs from 2012 to 2020 were collected and included from the National Surgical Quality Improvement Program. Patients were stratified by age into those younger than 55 years, between 55 and 70 years, and older than 70 years. Demographics, medical comorbidities, American Society of Anesthesiology Physical Classification (ASA) class, operative time, 30-day complications, and comorbid conditions were compared by univariable analysis. Multivariable analysis was used to analyze readmission rates, reoperation rates, operative time, and hospital length of stay. Results Patients younger than 55 years were found to have a significantly longer operative time compared to patients older than 70 years of age or between 55 and 70 years (P < .001, P = .034). Patients older than 70 years were found to have a significantly longer hospital stay (P < .001) and a greater risk of discharging to a nonhome location (P < .001). By multivariable analysis, patients 55 to 70 have a statistically lower risk of readmission compared to the other 2 cohorts (P = .043). No difference in postoperative complications was demonstrated between the different groups. Conclusions As the incidence of total ankle arthroplasty increases across all ages, it is important to understand specific perioperative risks for each age group. Younger patients tended to have longer surgeries and higher body mass indexes (BMIs). Patients aged 55 to 70 years had the lowest risks for perioperative complications. Patients greater than 70 years were at risk for longer hospital stays and discharge to nonhome locations. There were no differences in postoperative complications by age. Level of Evidence: Level III: Retrospective comparative study