Abstract
Background
Currently, no consensus exists for selection criteria of appropriate candidates for
outpatient total hip arthroplasty (THA). This study evaluates patient characteristics
associated with same-day discharge, examined surgical start time’s effect on rates
of same-day discharge, and compares readmission and reoperation rates between groups.
Methods
All patients who underwent a THA by one surgeon at a single quaternary care hospital
between February 2016 and May 2018 were captured. All patients were given the option
for same-day discharge. Patient characteristics and perioperative variables were analyzed.
Results
A total of 429 patients met inclusion criteria, 153 (36%) were discharged on the day
of surgery. In a multivariate analysis, age (P = .000), multiple comorbidities (P = .004), and start time remained statistically significant (P = .000). Patients with start times prior to 9 AM had odds ratio of 11.56 of being
discharged same day when compared to those with start times after 12 PM. Patients
discharged the day of surgery were less likely to have a 90-day emergency room visit
(P = .010), a readmission within 30 days (P = .001) or 90 days (P = .000), or a reoperation (0 vs 14, P = .003).
Conclusion
Same-day discharge following THA is safe and feasible. Patient’s age and number of
comorbidities should be considered when developing selection criteria for same-day
discharge programs. Patients selected for same-day discharge should receive earlier
operating room start times.
Keywords
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Article info
Publication history
Published online: April 02, 2020
Accepted:
March 26,
2020
Received in revised form:
March 11,
2020
Received:
February 5,
2020
Footnotes
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2020.03.049.
Disclosure statement: None of the authors have financial or property competing interest in the subject matter or materials discussed.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Letter to the Editor on “Patient Characteristics and Surgical Start Time Affect Length of Stay Following Anterior Total Hip Arthroplasty”The Journal of ArthroplastyVol. 35Issue 11
- PreviewWe read with great interest the study by Martinkovich et al. on the factors affecting same-day discharge after primary total hip arthroplasty (THA) [1]. Their findings suggest that young and medically fit patients who have a surgery planned early in the day are likely candidates for early discharge, provided they meet the discharge requirements. However, we would like to highlight some of the difficulties experienced particularly in developing countries if same factors are considered to same-day discharge.
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