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Temporal trends in length of stay and readmissions after fast-track hip and knee arthroplasty

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@article{65640e6290ee4931b44df539d27bf79e,
title = "Temporal trends in length of stay and readmissions after fast-track hip and knee arthroplasty",
abstract = "INTRODUCTION: Implementation of fast-track protocols in total hip and knee arthroplasty (THA/TKA) has dramatically changed the perioperative care, leading to a subsequent reduction in post-operative length of stay (LOS) and mor-bidity. Previous investigations in Denmark have shown a reduction in LOS from about ten days in 2000 to four days in 2009. We aimed to describe temporal changes in LOS and readmissions within the context of a continuous multicentre collaboration focusing on enhancing recovery and reducing morbidity after fast-track THA and TKA.METHODS: We used an observational cohort design from nine Danish orthopaedic centres. All procedures were performed from January 2010 to August 2017. Data on LOS and 90-day readmissions were obtained from The Danish National Patient Registry. Cause of readmission and possible association with surgery were investigated using discharge summaries or health records.RESULTS: We included 36,608 procedures with a median age of 69 (range: 62-75) years of whom 58{\%} were women. LOS decreased from a median of three (range: 2-3) days in 2010 to one (range: 1-2) days in 2017. The proportion of patients with LOS > 4 days decreased from 9.6{\%} to 4.4{\%}. Still, 90-day readmissions remained stable throughout the period at ≈ 8{\%}.CONCLUSIONS: A reduction in both LOS and proportion of patients with prolonged LOS without an increase in readmission is possible within a multicentre collaboration aiming at enhancing recovery and reducing morbidity.FUNDING: The study was supported by an unconditional PhD grant from Lundbeckfonden to PBP (R230-2017-166).TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (NCT01515670).",
author = "Petersen, {Pelle Baggesgaard} and J{\o}rgensen, {Christoffer Calov} and Henrik Kehlet",
note = "Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.",
year = "2019",
month = "7",
language = "English",
volume = "66",
journal = "Danish Medical Bulletin (Online)",
issn = "1603-9629",
publisher = "Almindelige Danske Laegeforening",
number = "7",

}

RIS

TY - JOUR

T1 - Temporal trends in length of stay and readmissions after fast-track hip and knee arthroplasty

AU - Petersen, Pelle Baggesgaard

AU - Jørgensen, Christoffer Calov

AU - Kehlet, Henrik

N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

PY - 2019/7

Y1 - 2019/7

N2 - INTRODUCTION: Implementation of fast-track protocols in total hip and knee arthroplasty (THA/TKA) has dramatically changed the perioperative care, leading to a subsequent reduction in post-operative length of stay (LOS) and mor-bidity. Previous investigations in Denmark have shown a reduction in LOS from about ten days in 2000 to four days in 2009. We aimed to describe temporal changes in LOS and readmissions within the context of a continuous multicentre collaboration focusing on enhancing recovery and reducing morbidity after fast-track THA and TKA.METHODS: We used an observational cohort design from nine Danish orthopaedic centres. All procedures were performed from January 2010 to August 2017. Data on LOS and 90-day readmissions were obtained from The Danish National Patient Registry. Cause of readmission and possible association with surgery were investigated using discharge summaries or health records.RESULTS: We included 36,608 procedures with a median age of 69 (range: 62-75) years of whom 58% were women. LOS decreased from a median of three (range: 2-3) days in 2010 to one (range: 1-2) days in 2017. The proportion of patients with LOS > 4 days decreased from 9.6% to 4.4%. Still, 90-day readmissions remained stable throughout the period at ≈ 8%.CONCLUSIONS: A reduction in both LOS and proportion of patients with prolonged LOS without an increase in readmission is possible within a multicentre collaboration aiming at enhancing recovery and reducing morbidity.FUNDING: The study was supported by an unconditional PhD grant from Lundbeckfonden to PBP (R230-2017-166).TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (NCT01515670).

AB - INTRODUCTION: Implementation of fast-track protocols in total hip and knee arthroplasty (THA/TKA) has dramatically changed the perioperative care, leading to a subsequent reduction in post-operative length of stay (LOS) and mor-bidity. Previous investigations in Denmark have shown a reduction in LOS from about ten days in 2000 to four days in 2009. We aimed to describe temporal changes in LOS and readmissions within the context of a continuous multicentre collaboration focusing on enhancing recovery and reducing morbidity after fast-track THA and TKA.METHODS: We used an observational cohort design from nine Danish orthopaedic centres. All procedures were performed from January 2010 to August 2017. Data on LOS and 90-day readmissions were obtained from The Danish National Patient Registry. Cause of readmission and possible association with surgery were investigated using discharge summaries or health records.RESULTS: We included 36,608 procedures with a median age of 69 (range: 62-75) years of whom 58% were women. LOS decreased from a median of three (range: 2-3) days in 2010 to one (range: 1-2) days in 2017. The proportion of patients with LOS > 4 days decreased from 9.6% to 4.4%. Still, 90-day readmissions remained stable throughout the period at ≈ 8%.CONCLUSIONS: A reduction in both LOS and proportion of patients with prolonged LOS without an increase in readmission is possible within a multicentre collaboration aiming at enhancing recovery and reducing morbidity.FUNDING: The study was supported by an unconditional PhD grant from Lundbeckfonden to PBP (R230-2017-166).TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (NCT01515670).

M3 - Journal article

VL - 66

JO - Danish Medical Bulletin (Online)

JF - Danish Medical Bulletin (Online)

SN - 1603-9629

IS - 7

M1 - A5553

ER -

ID: 57515418