Discharge Home is Associated With Decreased Early Complications Following Primary Total Joint Arthroplasty

Mayer, Michael; Pirruccio, Kevin; Sloan, Matthew; Sheth, Neil P.

doi:10.1016/j.arth.2019.06.049

Cited by 25 publications

(18 citation statements)

References 7 publications

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“…40 This high referral pattern contrasts with evidence to suggest that functional outcomes for those attending inpatient rehabilitation are not superior in randomised controlled trials to those discharged to home or community-based rehabilitation. 40,41 A recent landmark Australian study, the HIHO randomised clinical trial, compared outcomes for patients with TKRs discharged to inpatient rehabilitation with those who completed a supervised home-based program, finding no differences between groups for mobility, reported pain and function, or quality of life. 40 Although a formal cost analysis was not performed in this trial, the results suggest that healthcare system costs can be reduced without harming patient outcomes.…”

Section: Length Of Stay Outpatient Arthroplasty and Discharge Destinmentioning

confidence: 99%

Changes to rehabilitation after total knee replacement

Sattler¹,

Hing²,

Vertullo³

2020

Aust J Gen Pract

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Section: Length Of Stay Outpatient Arthroplasty and Discharge Destinmentioning

confidence: 99%

Changes to rehabilitation after total knee replacement

Sattler¹,

Hing²,

Vertullo³

2020

Aust J Gen Pract

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“…Discharge criteria Previous studies emphasize that discharge criteria vary worldwide and suggest that patients discharged quickly tend to display a decrease in early complications following primary THA when clinically appropriate [9,10]. The discharge criteria in our department are as follows.…”

Section: Patients Selectionmentioning

confidence: 99%

Patient Characteristics and Medical Provider Factors Are Associated With Length of Stay in Total Hip Arthroplasty Patients: a Retrospective Chinese Cohort Study

Zeng¹,

Li²,

Yu³

et al. 2020

Preprint

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Background Total hip arthroplasty (THA) is a successful treatment in the improvement of quality of life. Diagnosis-related groups (DRGs) payment has a significant impact on the hospital market in China and length of stay (LOS) is one of its crucial manifestations. Patient characteristics and medical provider factors can affect LOS but the relationship is uncertain. We intent to explore the relationship between patient characteristics and medical provider factors and LOS of primary THA patients. Methods We reviewed the database containing 461 patients who underwent primary THA between January 2014 to January 2019 and regressed the LOS against a variety of perioperative factors. A multivariable linear regression model was performed to assess the difference. Results For parts of patient characteristics, multivariable linear regression analysis revealed that comorbidities, pre-operation albumin < 30 g/L, and pre-operation CRP ≥ 5 mg/L were all significantly associated with LOS (p < 0.05). For parts of medical provider factors, multivariable linear regression analysis revealed that date of surgery, urinary catheter, and incision drainage were all significantly associated with LOS (p < 0.05). Conclusions Patient characteristics and medical provider factors are associated with LOS of THA patients. Evaluation and identification of risk factors are beneficial in patients' education, perioperative discussion and surgery decisions in the different primary THA patient populations.

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“…Total Joint Arthroplasty (TJA) is reportedly the most frequent procedure leading to post-acute admission to an Inpatient Rehabilitation Facility (IRF), representing one of the most significant costs associated with TKA [4,5]. Acute post-discharge care following primary TKA can account for up to 37% of the total procedure cost, with home discharge reported as costing $16,000 less than discharge to an IRF in the United States [6,7]. While IRF patients receive multidisciplinary input such as physical therapy and occupational therapy, this has yet to translate into evidence for improved functional outcomes when compared with TKA patients discharged directly to home [8,9].…”

Section: Introductionmentioning

confidence: 99%

Intrinsic patient factors predictive of inpatient rehabilitation facility discharge following primary total knee arthroplasty: a systematic review and meta-analysis

Sattler

Hing

Rathbone

et al. 2020

BMC Musculoskelet Disord

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Background: Total Knee Arthroplasty (TKA) reduces pain and improves function in those suffering from severe osteoarthritis. A significant cost of TKA is post-acute care, however, current evidence suggests that discharge to an Inpatient Rehabilitation Facility (IRF) has inferior outcomes to home discharge, with no greater benefit in physical function. Only individual studies have investigated TKA patient characteristics predictive of discharge destination, therefore, the aim is to systematically review the literature and meta-analyse intrinsic patient factors predictive of IRF discharge. If predictive factors are known, then early discharge planning and intervention strategies could be implemented. Methods: Databases PubMed, CINAHL, Embase, Cochrane, and Pedro were searched up to October 2019 for all studies investigating pre-operative intrinsic patient factors predictive of IRF discharge. For assessing the methodological quality of included studies, the Quality In Prognosis Studies (QUIPS) tool was used. Statistical analysis and graphical reporting were conducted in R statistical software. To assess the effect of predictors of discharge destination, odds ratios with the corresponding 95%CI were extracted from the results of univariate and multivariable analyses. Results: A total of 9 articles published between 2011 to 2018 with 218,151 TKA patients were included. Of the 13 intrinsic patient factors reported, 6 met the criteria for synthesised review: age, obesity, comorbidity, gender, SF-12/VR-12 survey, and smoking. Due to the heterogeneity of statistical analysis and reporting 2 variables could undergo meta-analysis, gender and smoking. Female gender increased the likelihood of IRF discharge by 78% (OR = 1.78; 95%CI = 1.43-2.20; I2 = 33.3%), however, the relationship between smoking status and discharge destination was less certain (OR = 0.80; 95%CI = 0.42-1.50; I2 = 68.5%).

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Discharge Home is Associated With Decreased Early Complications Following Primary Total Joint Arthroplasty

Cited by 25 publications

References 7 publications

Changes to rehabilitation after total knee replacement

Changes to rehabilitation after total knee replacement

Patient Characteristics and Medical Provider Factors Are Associated With Length of Stay in Total Hip Arthroplasty Patients: a Retrospective Chinese Cohort Study

Intrinsic patient factors predictive of inpatient rehabilitation facility discharge following primary total knee arthroplasty: a systematic review and meta-analysis

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