Pre-operative patient education reduces length of stay after knee joint arthroplasty

Jones, Samantha; Alnaib, Mustafa; Kokkinakis, Michail; Wilkinson, Mick; Gibson, Alan St Clair; Kader, Deiary F.

doi:10.1308/003588410x12771863936765

Cited by 133 publications

(87 citation statements)

References 23 publications

(35 reference statements)

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“…However, Mahomed et al [16] reported a readmission rate of only 0.9% in a similar Medicare cohort. Huddleston et al suggested that their higher readmission rate might be the result of earlier discharge after TKA, although this explanation remains controversial [4,9,22]. The low readmission rate reported by Mahomed et al may also be the result of how they defined readmission, which was limited to a specific list of diagnoses rather than a true all-cause readmission rate.…”

Section: Discussionmentioning

confidence: 98%

What Are the Rates and Causes of Hospital Readmission After Total Knee Arthroplasty?

Schairer

Vail

Bozic

2014

Clinical Orthopaedics &Amp; Related Research

203

142

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Background Total knee arthroplasty (TKA) and related interventions such as revision TKA and the treatment of infected TKAs are commonly performed procedures. Hospital readmission rates are used to measure hospital performance, but risk factors (both medical and surgical) for readmission after TKA, revision TKA, and treatment for the infected TKA have not been well characterized. Questions/purposes We measured (1) the unplanned hospital readmission rate in primary TKA and revision TKA, including antibiotic-spacer staged revision TKA to treat infection. We also evaluated (2) the medical and surgical causes of readmission and (3) risk factors associated with unplanned hospital readmission. Methods This retrospective cohort study included a total of 1408 patients (1032 primary TKAs, 262 revision TKAs, 113 revision of infected TKAs) from one institution. All hospital readmissions within 90 days of discharge were evaluated for timing and cause. Diagnoses at readmission were categorized as surgical or medical. Readmission risk was assessed using a Cox proportional hazards model that incorporated patient demographics and medical comorbidities. Results The unplanned readmission rate for the entire cohort was 4% at 30 days and 8% at 90 days. At 90 days postoperatively, revision of an infected TKA had the highest readmission rate, followed by revision TKA, with primary TKA having the lowest rate. Approximately threefourths of readmissions were the result of surgical causes, mostly infection, arthrofibrosis, and cellulitis, whereas the remainder of readmissions were the result of medical causes. Procedure type (primary TKA versus revision TKA or staged treatment for infected TKA), hospital stay more than 5 days, discharge destination, and a fluid/electrolyte abnormality were each associated with risk of unplanned readmission.

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Section: Discussionmentioning

confidence: 98%

What Are the Rates and Causes of Hospital Readmission After Total Knee Arthroplasty?

Schairer

Vail

Bozic

2014

Clinical Orthopaedics &Amp; Related Research

203

142

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“…Wang (2002) have found that the introduction of an education programme resulted in improved quality of gait and endurance at 6 months [17]. There was also reduction in hospital length of stay when combined with rehearsal of postoperative exercises resulting in cost savings, which has been supported by other studies in current literature [16]- [18]. Furthermore, the assessment of patient's home and family environment by nurses and physiotherapists before surgery increased patient satisfaction and lightened postoperative management [10].…”

Section: Educationmentioning

confidence: 80%

Approaches to Delivery of Care at Home Following Elective Hip and Knee Joint Replacement Surgery

Alnaib¹,

Agni²,

Shaw³

2015

OJTR

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Arthritis has a worldwide increasing prevalence with increased demands on healthcare systems to provide arthroplasty surgery. There is growing evidence that early discharge and rehabilitation at home following hip and knee replacement provide similar or better results in function, complication rates and patient satisfaction. We suggest that this method of rehabilitation is a cost-effective viable option in fitter patients whose medical demands will be low postoperatively.

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“…A more recent review linked preoperative education to improved patient outcomes including lower hospital length of stay, higher home discharge, lower readmission and improved costs [2]. Additionally, other recent evidence that was not included in the Cochrane review has demonstrated that the provision of preoperative education is linked to a reduction in hospital length of stay [4][5][6][7].…”

Section: Main Text Backgroundmentioning

confidence: 99%

An eHealth Program for Patients Undergoing a Total Hip Arthroplasty: Protocol for a Randomized Controlled Trial (Preprint)

Saunders¹,

Seaman²,

Ashford³

et al. 2017

Preprint

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Pre-operative patient education reduces length of stay after knee joint arthroplasty

Abstract: The results suggest that pre-operative education is a safe and effective method of reducing length of stay for knee arthroplasty patients.

Cited by 133 publications

References 23 publications

What Are the Rates and Causes of Hospital Readmission After Total Knee Arthroplasty?

What Are the Rates and Causes of Hospital Readmission After Total Knee Arthroplasty?

Approaches to Delivery of Care at Home Following Elective Hip and Knee Joint Replacement Surgery

An eHealth Program for Patients Undergoing a Total Hip Arthroplasty: Protocol for a Randomized Controlled Trial (Preprint)

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