Predictors of Length of Hospital Stay after Total Hip Replacement

Abbas, Khawar; Umer, Masood; Qadir, Irfan; Zaheer, Jaweria; Rashid, Haroon

doi:10.1177/230949901101900304

Cited by 40 publications

(63 citation statements)

References 11 publications

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“…Furthermore, increased ASA score has been described as a predictor of prolonged hospital stay (Husted et al 2008, Foote et al 2009, Mears et al 2009, Abbas et al 2011), which could be explained by the association of ASA score with comorbidities. In our fast-track setting, however, there was no effect of ASA score on LOS in a multivariate logistic regression model, confirming the results of den Hartog et al (2015).…”

Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty in an outpatient setting in 27 selected patients

Hartog¹,

Mathijssen²,

Vehmeijer³

2015

Acta Orthopaedica

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Background and purpose — As a result of introduction of a fast-track program, length of hospital stay after total hip arthroplasty (THA) decreased in our hospital. We therefore wondered whether THA in an outpatient setting would be feasible. We report our experience with THA in an outpatient setting.Patients and methods — In this prospective cohort study, we included 27 patients who were selected to receive primary THA in an outpatient setting between April and July 2014. Different patient-reported outcome measures (PROMs) were recorded preoperatively and at 6 weeks and 3 months postoperatively. Furthermore, anchor questions on how patients functioned in daily living were scored at 6 weeks and 3 months postoperatively.Results — 3 of the 27 patients did not go home on the day of surgery because of nausea and/or dizziness. The remaining 24 patients all went home on the day of surgery. PROMs improved substantially in these patients. Moreover, anchor questions on how patients functioned in their daily living indicated that the patients were satisfied with the postoperative results. 1 re-admission occurred at 11 days after surgery because of seroma formation. There were no other complications or reoperations.Interpretation — At our hospital, with a fast-track protocol, outpatient THA was found to be feasible in selected patients with satisfying results up to 3 months postoperatively, without any outpatient procedure-specific complications or re-admissions.

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Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty in an outpatient setting in 27 selected patients

Hartog¹,

Mathijssen²,

Vehmeijer³

2015

Acta Orthopaedica

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“…However in our country, analgesic medication before surgery is not routinely prescribed. Most patients having a total hip replacement will not stay in the hospital longer than 5 days in the United States, but in Pakistan, the median length of a hospital stay for patients undergoing the same surgery is longer than 10 days [1]. These differences in treating patients may be attributed to disparate medical service standards, economic situations, and hospital scales in different countries.…”

Section: Discussionmentioning

confidence: 99%

“…We therefore determined: (1) whether the addition of parecoxib to ropivacaine injected locally on the nerve block affected the sensory and motor block times of the brachial plexus nerve block; and (2) whether parecoxib injected locally on the brachial plexus nerve or injected intravenously had a similar analgesic adjuvant effect or which one was better.…”

mentioning

confidence: 99%

Parecoxib Added to Ropivacaine Prolongs Duration of Axillary Brachial Plexus Blockade and Relieves Postoperative Pain

Liu

Zhao

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Cyclooxygenase (COX)-2 antagonist is widely used for intravenous postoperative pain relief. Recent studies reported COX-2 in the spinal dorsal horn could modulate spinal nociceptive processes. Epidural parecoxib in rats showed no neurotoxicity. These findings suggested applying a COX-2 antagonist directly to the central or peripheral nerve might provide better analgesia. Questions/purposes We therefore determined: (1) whether the addition of parecoxib to ropivacaine injected locally on the nerve block affected the sensory and motor block times of the brachial plexus nerve block; and (2) whether parecoxib injected locally on the nerve or intravenously had a similar analgesic adjuvant effect.Methods We conducted a randomized controlled trial from January 2009 to November 2010 with 150 patients scheduled for elective forearm surgery, using a multiplenerve stimulation technique. Patients were randomly allocated into one of three groups: Group A (n = 50) received ropivacaine 0.25% alone on the brachial plexus nerve; Group B (n = 50) received ropivacaine together with 20 mg parecoxib locally on the nerve block; and Group C (n = 50) received 20 mg parecoxib intravenously. We recorded the duration of the sensory and motor blocks, and the most severe pain score during a 24-hour postoperative period.

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“…Previous studies have identified several factors that influence LOS after primary THA, including age [9][10][11][12], sex [9,10,12], comorbidities [12,13], body mass index [14], surgical approach [15], use of assistive devices [16], functional status [12], general health perception [10,13], and surgeon experience [10]. However, many of those studies had significantly long mean LOS [9,10], excluded patients with diagnoses other than primary osteoarthritis [16], focused only on select comorbidities [12], or required the use of time-consuming scoring systems [10,13].…”

mentioning

confidence: 99%

“…However, many of those studies had significantly long mean LOS [9,10], excluded patients with diagnoses other than primary osteoarthritis [16], focused only on select comorbidities [12], or required the use of time-consuming scoring systems [10,13]. Furthermore, previous studies often had postoperative rehabilitation protocols geared toward discharge to home [16], which has limited application to current practice where patients with slow postoperative recovery can be discharged to ECF.…”

mentioning

confidence: 99%

Preoperative Pain Level and Patient Expectation Predict Hospital Length of Stay After Total Hip Arthroplasty

Halawi

Vovos

Green

et al. 2015

The Journal of Arthroplasty

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a b s t r a c t a r t i c l e i n f oThe purpose of this study was to identify preoperative predictors of length of stay after primary total hip arthroplasty in a patient population reflecting current trends toward shorter hospitalization and using readily obtainable factors that do not require scoring systems. A retrospective review of 112 consecutive patients was performed. High preoperative pain level and patient expectation of discharge to extended care facilities (ECFs) were the only significant multivariable predictors of hospitalization extending beyond 2 days (P = 0.001 and P b 0.001 respectively). Patient expectation remained significant after adjusting for Medicare's 3-day requirement for discharge to ECFs (P b 0.001). The study was adequately powered to analyze the variables in the multivariable logistic regression model, which had a concordance index of 0.857.

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Predictors of Length of Hospital Stay after Total Hip Replacement

Abstract: Prolonged hospital stay after THR is largely predetermined by case mix. Our study helps to identify individuals who need longer rehabilitation and more care.

Cited by 40 publications

References 11 publications

Total hip arthroplasty in an outpatient setting in 27 selected patients

Total hip arthroplasty in an outpatient setting in 27 selected patients

Parecoxib Added to Ropivacaine Prolongs Duration of Axillary Brachial Plexus Blockade and Relieves Postoperative Pain

Preoperative Pain Level and Patient Expectation Predict Hospital Length of Stay After Total Hip Arthroplasty

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