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Short-Stay Arthroplasty is Not Associated With Increased Risk of 90-Day Hospital Returns.

Publication ,  Journal Article
Wu, CJ; Ryan, SP; Hinton, ZW; Charalambous, LT; Wellman, SS; Bolognesi, MP; Seyler, TM
Published in: J Arthroplasty
August 2022

BACKGROUND: With the removal of total hip arthroplasty (THA) and total knee arthroplasty (TKA) from the inpatient-only list, medical centers are faced with challenging transitions to outpatient surgery. We investigated if short-stay arthroplasty, defined as length of stay (LOS) <24 hours, would influence 90-day readmissions and emergency department (ED) visits at a tertiary referral center. METHODS: The institutional database was retrospectively queried for primary TKAs and THAs from July 2015 to January 2018, resulting in 2,217 patients (1,361 TKA and 856 THA). Patient demographics, including age, gender, body mass index, and American Society of Anesthesiologists score were collected. LOS, disposition, cost of care, 90-day ED visits, and readmissions were identified through the institutional database using electronic medical record data. Univariable and multivariable models were used to evaluate rates of 90-day readmissions and ED visits based on LOS <24 hours vs ≥24 hours. RESULTS: LOS <24 h was associated with significant decreases in 90-day ED visits (P = .003) and readmissions (P = .002). After controlling for potential confounding variables with a multivariable model, a significant decrease in ED visits (P = .034) remained in the THA cohort alone. Within TKA and THA cohorts, LOS <24 h was associated with lower costs (P < .001). Eighteen percent of patients with ≥24 h LOS were discharged to skilled nursing or rehabilitation facilities. CONCLUSION: In this cohort, LOS <24 hours was associated with decreased 90-day readmissions, ED visits, and costs. With the goal of minimizing costs and maintaining patient safety while efficiently using resources, outpatient and short-stay arthroplasty are valuable, feasible options in tertiary academic centers.

Duke Scholars

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

August 2022

Volume

37

Issue

8S

Start / End Page

S819 / S822

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Patient Readmission
  • Patient Discharge
  • Orthopedics
  • Length of Stay
  • Humans
  • Hospitals
  • Arthroplasty, Replacement, Hip
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wu, C. J., Ryan, S. P., Hinton, Z. W., Charalambous, L. T., Wellman, S. S., Bolognesi, M. P., & Seyler, T. M. (2022). Short-Stay Arthroplasty is Not Associated With Increased Risk of 90-Day Hospital Returns. J Arthroplasty, 37(8S), S819–S822. https://doi.org/10.1016/j.arth.2022.01.050
Wu, Christine J., Sean P. Ryan, Zoe W. Hinton, Lefko T. Charalambous, Samuel S. Wellman, Michael P. Bolognesi, and Thorsten M. Seyler. “Short-Stay Arthroplasty is Not Associated With Increased Risk of 90-Day Hospital Returns.J Arthroplasty 37, no. 8S (August 2022): S819–22. https://doi.org/10.1016/j.arth.2022.01.050.
Wu CJ, Ryan SP, Hinton ZW, Charalambous LT, Wellman SS, Bolognesi MP, et al. Short-Stay Arthroplasty is Not Associated With Increased Risk of 90-Day Hospital Returns. J Arthroplasty. 2022 Aug;37(8S):S819–22.
Wu, Christine J., et al. “Short-Stay Arthroplasty is Not Associated With Increased Risk of 90-Day Hospital Returns.J Arthroplasty, vol. 37, no. 8S, Aug. 2022, pp. S819–22. Pubmed, doi:10.1016/j.arth.2022.01.050.
Wu CJ, Ryan SP, Hinton ZW, Charalambous LT, Wellman SS, Bolognesi MP, Seyler TM. Short-Stay Arthroplasty is Not Associated With Increased Risk of 90-Day Hospital Returns. J Arthroplasty. 2022 Aug;37(8S):S819–S822.
Journal cover image

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

August 2022

Volume

37

Issue

8S

Start / End Page

S819 / S822

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Patient Readmission
  • Patient Discharge
  • Orthopedics
  • Length of Stay
  • Humans
  • Hospitals
  • Arthroplasty, Replacement, Hip