Evaluation of the effect of comorbidity factors of patients with total knee or hip arthroplasty on perceived care burden in caregivers and rehospitalization

This study aims to examine the effect of comorbidities on care burden for caregivers and rehospitalization in patients who underwent primary total hip and knee replacement surgery. In this descriptive and prospective study, 127 patients determined by easy sampling method who underwent primary total hip and knee replacement and their 127 caregivers were included. The data of the study were collected using Charlson comorbidity index (CCI), the American Society of Anesthesiologists (ASA), the Katz Activities of Daily Living Scale (ADL), Nurses' Assesment Form and the Turkish version of Zarit Care Burden Scale between June 2019 - January 2020. By analyzing the clinical data of the patients, the effect on rehospitalization was analyzed using Chi-square, Univariate Logistic Regression and Pearson Correlation. The effect of ADL and CCI on caregiving burden was analyzed by Multiple Linear Regression. p <0.05 was considered statistically significant. 79.5% of the patients were female and their mean age was 63.35 ± 9.679. The 30-day rehospitalization rate was 14.2%, and the most common reason for rehospitalization was surgical infection. Patients were scored using this CCI system and grouped as high (high CCI group >2, n = 49) and low CCI (low CCI group ≤2, n = 78) with a cut-off score of 2. ASA, Katz ADL and CCI scores of the patients were not determined as a risk factor for rehospitalization (p> 0.05). 40.2% of the caregivers were the daughters of the patient, Zarit Care burden scores were 34.34 ± 21.55, and 39.4% of the caregivers were under moderate burden. It was observed that the patient's functional status, pain score, Braden and Fall risk scores did not affect rehospitalization and care burden. However, the duration of hospital stays, CCI and Katz ADL scores were found to be factors affecting the care burden (p <0.05). CCI and Katz ADL may not be sufficient to estimate the risk of rehospitalization after total hip and knee replacement surgery but can be used to estimate the care burden.