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Complications and readmissions following outpatient total hip and knee arthroplasty: a prospective 2-center study with matched controls

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@article{1c2f30b24dfb4f8eb3d720885e7e83cf,
title = "Complications and readmissions following outpatient total hip and knee arthroplasty: a prospective 2-center study with matched controls",
abstract = "Background and purpose - Outpatient arthroplasty has gained popularity in recent years; however, safety concerns still remain regarding complications and readmissions. In a prospective 2-center study we investigated early readmissions with overnight stay and complications following outpatient total hip (THA) and total knee arthroplasty (TKA) compared with a matched patient cohort with at least 1 postoperative night in hospital. Patients and methods - All consecutive and unselected patients scheduled for THA or TKA at 2 participating hospitals were screened for potential day of surgery (DOS) discharge. Patients who fulfilled the DOS discharge criteria were discharged home. Patients discharged on DOS were matched on preoperative characteristics using propensity scores to patients operated at the same 2 departments prior to the beginning of this study with at least 1 overnight stay. All readmissions within 90 days were identified. Results - It was possible to match 116 of 138 outpatients with 339 inpatient controls. Median LOS in the control cohort was 2 days (1-9). 7 (6{\%}) outpatients and 13 (4{\%}) inpatient controls were readmitted within 90 days. Readmissions occurred between postoperative day 2-48 and day 4-58 in the outpatient and control cohorts, respectively. Importantly, we found no readmissions within the first 48 hours and no readmissions were related to the DOS discharge. Interpretation - Readmission rates in patients discharged on DOS may be similar to matched patients with at least 1 overnight stay. With the selection criteria used, there may be no safety signal associated with same-day discharge.",
keywords = "Aged, Ambulatory Surgical Procedures/methods, Arthroplasty, Replacement, Hip/methods, Arthroplasty, Replacement, Knee/methods, Denmark/epidemiology, Female, Hospitalization, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Patient Readmission/statistics & numerical data, Postoperative Complications/epidemiology, Prospective Studies, Venous Thrombosis/epidemiology",
author = "Kirill Gromov and J{\o}rgensen, {Christoffer Calov} and Petersen, {Pelle Baggesgaard} and Per Kjaersgaard-Andersen and Peter Revald and Anders Troelsen and Henrik Kehlet and Henrik Husted",
year = "2019",
doi = "10.1080/17453674.2019.1577049",
language = "English",
volume = "90",
pages = "281--285",
journal = "Acta Orthopaedica",
issn = "1745-3674",
publisher = "Taylor & Francis Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - Complications and readmissions following outpatient total hip and knee arthroplasty

T2 - a prospective 2-center study with matched controls

AU - Gromov, Kirill

AU - Jørgensen, Christoffer Calov

AU - Petersen, Pelle Baggesgaard

AU - Kjaersgaard-Andersen, Per

AU - Revald, Peter

AU - Troelsen, Anders

AU - Kehlet, Henrik

AU - Husted, Henrik

PY - 2019

Y1 - 2019

N2 - Background and purpose - Outpatient arthroplasty has gained popularity in recent years; however, safety concerns still remain regarding complications and readmissions. In a prospective 2-center study we investigated early readmissions with overnight stay and complications following outpatient total hip (THA) and total knee arthroplasty (TKA) compared with a matched patient cohort with at least 1 postoperative night in hospital. Patients and methods - All consecutive and unselected patients scheduled for THA or TKA at 2 participating hospitals were screened for potential day of surgery (DOS) discharge. Patients who fulfilled the DOS discharge criteria were discharged home. Patients discharged on DOS were matched on preoperative characteristics using propensity scores to patients operated at the same 2 departments prior to the beginning of this study with at least 1 overnight stay. All readmissions within 90 days were identified. Results - It was possible to match 116 of 138 outpatients with 339 inpatient controls. Median LOS in the control cohort was 2 days (1-9). 7 (6%) outpatients and 13 (4%) inpatient controls were readmitted within 90 days. Readmissions occurred between postoperative day 2-48 and day 4-58 in the outpatient and control cohorts, respectively. Importantly, we found no readmissions within the first 48 hours and no readmissions were related to the DOS discharge. Interpretation - Readmission rates in patients discharged on DOS may be similar to matched patients with at least 1 overnight stay. With the selection criteria used, there may be no safety signal associated with same-day discharge.

AB - Background and purpose - Outpatient arthroplasty has gained popularity in recent years; however, safety concerns still remain regarding complications and readmissions. In a prospective 2-center study we investigated early readmissions with overnight stay and complications following outpatient total hip (THA) and total knee arthroplasty (TKA) compared with a matched patient cohort with at least 1 postoperative night in hospital. Patients and methods - All consecutive and unselected patients scheduled for THA or TKA at 2 participating hospitals were screened for potential day of surgery (DOS) discharge. Patients who fulfilled the DOS discharge criteria were discharged home. Patients discharged on DOS were matched on preoperative characteristics using propensity scores to patients operated at the same 2 departments prior to the beginning of this study with at least 1 overnight stay. All readmissions within 90 days were identified. Results - It was possible to match 116 of 138 outpatients with 339 inpatient controls. Median LOS in the control cohort was 2 days (1-9). 7 (6%) outpatients and 13 (4%) inpatient controls were readmitted within 90 days. Readmissions occurred between postoperative day 2-48 and day 4-58 in the outpatient and control cohorts, respectively. Importantly, we found no readmissions within the first 48 hours and no readmissions were related to the DOS discharge. Interpretation - Readmission rates in patients discharged on DOS may be similar to matched patients with at least 1 overnight stay. With the selection criteria used, there may be no safety signal associated with same-day discharge.

KW - Aged

KW - Ambulatory Surgical Procedures/methods

KW - Arthroplasty, Replacement, Hip/methods

KW - Arthroplasty, Replacement, Knee/methods

KW - Denmark/epidemiology

KW - Female

KW - Hospitalization

KW - Humans

KW - Length of Stay/statistics & numerical data

KW - Male

KW - Middle Aged

KW - Patient Readmission/statistics & numerical data

KW - Postoperative Complications/epidemiology

KW - Prospective Studies

KW - Venous Thrombosis/epidemiology

UR - http://www.scopus.com/inward/record.url?scp=85061442698&partnerID=8YFLogxK

U2 - 10.1080/17453674.2019.1577049

DO - 10.1080/17453674.2019.1577049

M3 - Journal article

VL - 90

SP - 281

EP - 285

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

IS - 3

ER -

ID: 56510989