The effect of preoperative sleep quality on early recovery after total knee arthroplasty: a prospective cohort study

FANG Ying-lei; LU Ming; HUANG Fei; YIN Zong-sheng

doi:10.13820/j.cnki.gdyx.20183346

Abstract：Objective To investigate the effect of preoperative sleep quality on early recovery after total knee arthroplasty. Methods 302 patients undergoing TKA who meet the inclusion criteria were enrolled in the study. They were grouped according to the score of preoperative sleep quality(using the Pittsburgh Sleep Quality Index), and 124 cases were included in the high sleep quality group(HSQG)with a score of less than 7 points, while 178 cases were assigned into low sleep quality group(LSQG)with a score greater than 7 points. The outcomes including the resting state VAS(Visual Analogue Scale, VAS)pain score postoperative 24 h and 72 h, postoperative hospital stay, the number of days required for 90 degree of knee flexion, POD3 SCL-90 scores and patients' satisfaction(using Likert Scale)were observed. COX proportional hazards model was used to analyze the association between preoperative sleep quality and postoperative hospital stays. Results There was no significant difference in general information, such as age, sex, body mass index and preoperative knee joint HSS score, between the two groups. Compared to the LSQG group, the resting state VAS pain scores postoperative 24 h and 72 h, postoperative hospital stays, the number of days required for 90 degree of knee flexion, the anxiety and depression scores POD3 were significantly lower in the HSQG group(P ＜ 0.05). In HSQG group, the patients' satisfaction was significantly higher than that in LSQG group(P ＜ 0.05). While taking sleep quality as a categorical variable, the length of hospital stays in HSQG group was 0.677(95％ CI: 0.529-0.866)times of the LSQG group. Conclusion High preoperative sleep quality can accelerate recovery after total knee arthroplasty.