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

Ma Malahias, A Gu, Ss Richardson, Ivan De Martino, Mp Ast, Pk Sculco

Risultato della ricerca: Contributo in rivistaArticolo in rivista

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.
Lingua originaleEnglish
pagine (da-a)S107-S112
RivistaTHE JOURNAL OF ARTHROPLASTY
Volume35
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • total hip arthroplasty
  • same-day discharge
  • PearlDiver
  • postoperative complications
  • rapid recovery

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