Background: As health care costs continue to rise, same-day and rapid discharge have become popular options for total hip arthroplasty (THA). However, it remains unclear if there is a difference between within-a-day discharge and early discharge for 1-year clinical outcomes.Methods: Data were collected from the Humana insurance database using the PearlDiver Patient Records Database from 2007 to 2017, identifying patients receiving a primary THA. Patients were then stratified into three groups: (1) discharge within a day (length of stay [LOS] <24 hours), (2) rapid discharge (LOS: 1-2 days), and (3) traditional discharge (LOS: 3-4 days). The outcomes assessed were all-cause revision surgery, periprosthetic joint infection, prosthetic loosening, prosthetic dislocation, and periprosthetic fracture at 1 year postoperatively.Results: In total, 40,038 patients met inclusion criteria. Among those, 754 (1.88%) patients were discharged within a day, 13,670 (34.14%) patients were in the rapid discharge cohort, and 25,614 (63.97%) patients were in the traditional discharge cohort. After multivariate analysis, no significant differences were observed between the within-a-day discharge group and either the rapid discharge or the traditional discharge group. Rapid discharge patients were at decreased risk of periprosthetic joint infection (odds ratios: 0.747, 95% confidence interval: 0.623-0.896) and readmission (odds ratios: 0.778; 95% confidence interval: 0.735-0.824, P < .001) compared with traditional discharge patients.Conclusions: No significant differences were observed in the one-year outcomes of primary THA between within-a-day discharge patients, rapid discharge, and traditional discharge. For those that qualify after careful selection, outpatient THA might be a feasible alternative to the traditional inpatient THA. (C) 2019 Elsevier Inc. All rights reserved.

Malahias, M., Gu, A., Richardson, S., De Martino, I., Ast, M., Sculco, P., Hospital Discharge Within a Day After Total Hip Arthroplasty Does Not Compromise 1-Year Outcomes Compared With Rapid Discharge: An Analysis of an Insurance Claims Database, <<THE JOURNAL OF ARTHROPLASTY>>, 2020; 35 (6): S107-S112. [doi:10.1016/j.arth.2019.10.059] [https://hdl.handle.net/10807/305294]

Hospital Discharge Within a Day After Total Hip Arthroplasty Does Not Compromise 1-Year Outcomes Compared With Rapid Discharge: An Analysis of an Insurance Claims Database

De Martino, Ivan;
2020

Abstract

Background: As health care costs continue to rise, same-day and rapid discharge have become popular options for total hip arthroplasty (THA). However, it remains unclear if there is a difference between within-a-day discharge and early discharge for 1-year clinical outcomes.Methods: Data were collected from the Humana insurance database using the PearlDiver Patient Records Database from 2007 to 2017, identifying patients receiving a primary THA. Patients were then stratified into three groups: (1) discharge within a day (length of stay [LOS] <24 hours), (2) rapid discharge (LOS: 1-2 days), and (3) traditional discharge (LOS: 3-4 days). The outcomes assessed were all-cause revision surgery, periprosthetic joint infection, prosthetic loosening, prosthetic dislocation, and periprosthetic fracture at 1 year postoperatively.Results: In total, 40,038 patients met inclusion criteria. Among those, 754 (1.88%) patients were discharged within a day, 13,670 (34.14%) patients were in the rapid discharge cohort, and 25,614 (63.97%) patients were in the traditional discharge cohort. After multivariate analysis, no significant differences were observed between the within-a-day discharge group and either the rapid discharge or the traditional discharge group. Rapid discharge patients were at decreased risk of periprosthetic joint infection (odds ratios: 0.747, 95% confidence interval: 0.623-0.896) and readmission (odds ratios: 0.778; 95% confidence interval: 0.735-0.824, P < .001) compared with traditional discharge patients.Conclusions: No significant differences were observed in the one-year outcomes of primary THA between within-a-day discharge patients, rapid discharge, and traditional discharge. For those that qualify after careful selection, outpatient THA might be a feasible alternative to the traditional inpatient THA. (C) 2019 Elsevier Inc. All rights reserved.
2020
Inglese
Malahias, M., Gu, A., Richardson, S., De Martino, I., Ast, M., Sculco, P., Hospital Discharge Within a Day After Total Hip Arthroplasty Does Not Compromise 1-Year Outcomes Compared With Rapid Discharge: An Analysis of an Insurance Claims Database, <<THE JOURNAL OF ARTHROPLASTY>>, 2020; 35 (6): S107-S112. [doi:10.1016/j.arth.2019.10.059] [https://hdl.handle.net/10807/305294]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/305294
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