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Accelerated Discharge After Aseptic Revision Total Hip Arthroplasty Does Not Predict Inferior 30-Day Outcomes.

Publication ,  Journal Article
Cochrane, NH; Kim, BI; Seyler, TM; Bolognesi, MP; Wellman, SS; Ryan, SP
Published in: J Arthroplasty
March 2023

BACKGROUND: Perioperative advancements have made outpatient primary total hip arthroplasty (THA) a viable option for patients. This study evaluated the feasibility of expedited discharge after revision THA and compared 30-day outcomes to patients who had prolonged inpatient hospitalizations. The authors hypothesized that expedited discharge would not result in inferior 30-day outcomes. METHODS: Aseptic revision THAs in a national database were reviewed from 2013 to 2020. THAs were stratified by hospital length of stay (LOS) more or less than 24 hours. Demographics, comorbidities, preoperative laboratory values, American Society of Anesthesiology (ASA) scores, operative times, components revised, 30-day readmissions, and reoperations were compared. Multivariable analyses evaluated predictors of discharge prior to 24 hours, 30-day readmissions, and reoperations. Of 17,044 aseptic revision THAs, 211 were discharged within 24 hours. RESULTS: Accelerated discharge patients were younger, mean age 63 years (range, 20-92) versus 66 years (range, 18-94) (P < .01) had lower body mass index, mean 28.7 (range, 18.3-46.4) versus 29.9 (range, 17.3-52.5) (P = .01), and ASA scores (ASA, 1-2; 40.4-57.8%) (P < .01). Components revised had no association with LOS (P = .39); however, operative times were shorter and mean 100 minutes (range, 35-369) versus 139 minutes (range, 24-962) (P < .01) in accelerated discharge patients. Accelerated discharge patients had lower readmission rates (P < .01) but no difference in reoperation rates (P = .06). CONCLUSION: Discharge less than 24 hours after revision THA is a feasible option for the correct patient and further efforts to decrease LOS should be evaluated.

Duke Scholars

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

March 2023

Volume

38

Issue

3

Start / End Page

541 / 547

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Patient Readmission
  • Patient Discharge
  • Orthopedics
  • Middle Aged
  • Length of Stay
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cochrane, N. H., Kim, B. I., Seyler, T. M., Bolognesi, M. P., Wellman, S. S., & Ryan, S. P. (2023). Accelerated Discharge After Aseptic Revision Total Hip Arthroplasty Does Not Predict Inferior 30-Day Outcomes. J Arthroplasty, 38(3), 541–547. https://doi.org/10.1016/j.arth.2022.09.010
Cochrane, Niall H., Billy I. Kim, Thorsten M. Seyler, Michael P. Bolognesi, Samuel S. Wellman, and Sean P. Ryan. “Accelerated Discharge After Aseptic Revision Total Hip Arthroplasty Does Not Predict Inferior 30-Day Outcomes.J Arthroplasty 38, no. 3 (March 2023): 541–47. https://doi.org/10.1016/j.arth.2022.09.010.
Cochrane NH, Kim BI, Seyler TM, Bolognesi MP, Wellman SS, Ryan SP. Accelerated Discharge After Aseptic Revision Total Hip Arthroplasty Does Not Predict Inferior 30-Day Outcomes. J Arthroplasty. 2023 Mar;38(3):541–7.
Cochrane, Niall H., et al. “Accelerated Discharge After Aseptic Revision Total Hip Arthroplasty Does Not Predict Inferior 30-Day Outcomes.J Arthroplasty, vol. 38, no. 3, Mar. 2023, pp. 541–47. Pubmed, doi:10.1016/j.arth.2022.09.010.
Cochrane NH, Kim BI, Seyler TM, Bolognesi MP, Wellman SS, Ryan SP. Accelerated Discharge After Aseptic Revision Total Hip Arthroplasty Does Not Predict Inferior 30-Day Outcomes. J Arthroplasty. 2023 Mar;38(3):541–547.
Journal cover image

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

March 2023

Volume

38

Issue

3

Start / End Page

541 / 547

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Patient Readmission
  • Patient Discharge
  • Orthopedics
  • Middle Aged
  • Length of Stay
  • Humans