NSQIP Analysis Links COPD to Shorter Total Ankle Arthroplasty Operative Time and Longer Hospital Stay (2012–2020)

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• Per the Journal of Surgical Orthopaedic Advances (2025), a Level III NSQIP-based cohort (2012–2020; n=1,619) evaluated COPD as a risk factor in total ankle arthroplasty (TAA).
• COPD independently predicted shorter operative time (β = –0.33; p = 0.037) and longer hospital length of stay (β = 0.37; p = 0.039).
• No additional 30-day outcomes were reported as significantly associated; findings support closer perioperative planning for TAA patients with COPD.

A 2012–2020 NSQIP cohort study published in J Surg Orthop Adv (2025) examined postoperative outcomes in patients with chronic obstructive pulmonary disease undergoing total ankle arthroplasty. The analysis identified COPD as an independent predictor of shorter operative time but longer hospital length of stay, highlighting important considerations for perioperative planning.

Per Journal of Surgical Orthopaedic Advances, this Level III retrospective cohort used the National Surgical Quality Improvement Program (NSQIP) database to examine primary total ankle arthroplasty (CPT 27702) from 2012–2020.¹ Among 1,619 patients, the investigators compared baseline characteristics and 30-day postoperative outcomes for those with and without chronic obstructive pulmonary disease (COPD). Univariable analysis informed variable selection, followed by multivariable regression to isolate the effect of COPD.¹

In adjusted models, COPD was an independent predictor of shorter operative time (β = –0.33; p = 0.037) and increased hospital length of stay (β = 0.37; p = 0.039). The study also evaluated 30-day readmissions, though no significant associations with COPD were reported in the abstract.¹

These findings suggest that COPD may influence perioperative efficiency and postoperative resource utilization in TAA. A shorter operative duration coupled with longer length of stay may reflect unique perioperative management needs in this population. As a retrospective database analysis, results are limited by coding accuracy and unmeasured confounders. Per the authors, further investigation is warranted to clarify mechanisms and optimize perioperative pathways for TAA patients with COPD.¹