Discharge Destination of Patients in Fast-Track Primary Hip and Knee Arthroplasty: Results From a Prospective Danish Cohort

Following the implementation of the fast-track protocol in total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA), the median length of stay (LOS) has been significantly reduced without an increase in readmissions. However, it is unclear if the redu...

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Veröffentlicht in:The Journal of arthroplasty Jg. 40; H. 7; S. 1690 - 1695
Hauptverfasser: Lyndrup, Oliver, Kehlet, Henrik, Jørgensen, Christoffer C., Lindberg-Larsen, Martin, Jakobsen, Thomas, Gromov, Kirill, Andersen, Mikkel R., Bieder, Manuel, Overgaard, Søren, Varnum, Claus
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Inc 01.07.2025
Schlagworte:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - rehabilitation
Arthroplasty, Replacement, Knee - rehabilitation
Denmark
discharge destination
fast-track surgery
Female
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Patient Discharge - statistics & numerical data
Prospective Studies
Rehabilitation Centers - statistics & numerical data
rehabilitation facility
total hip arthroplasty
total knee arthroplasty
unicompartmental knee arthroplasty
Denmark
fast-track surgery
total hip arthroplasty
total knee arthroplasty
discharge destination
rehabilitation facility
unicompartmental knee arthroplasty
ISSN:0883-5403, 1532-8406, 1532-8406
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Zusammenfassung:Following the implementation of the fast-track protocol in total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA), the median length of stay (LOS) has been significantly reduced without an increase in readmissions. However, it is unclear if the reduction in LOS is at the expense of an increase in nonhome discharge. The aim of this study was to investigate the discharge destination among THA, TKA, and UKA patients. The prospective multicenter study included 6,856 patients undergoing primary THA, TKA, and UKA in a fast-track setting with an overall median LOS of one day. Outcomes were discharge destination, median LOS in each discharge destination category, and cause of rehabilitation center discharge. Data were gathered using preoperative questionnaires and a review of medical records. Discharge destination and LOS were registered at discharge. We found that 99% of patients had been discharged to their own homes, of which 21% had been discharged to their own homes with home care. There were 1% who were discharged to a rehabilitation facility and 0.1% who were discharged to a nursing home. The THA (1%, 95% confidence interval [CI] 0.7 to 1) and TKA (1%, 95% CI 0.9 to 2) had a significantly higher rate of discharge to a rehabilitation facility compared to UKA (0.1%, 95% CI 0.0 to 0.5). Despite a short LOS, 99% of patients were discharged to their own homes. Rehabilitation facility discharge was only 1% and was mostly caused by inadequate postoperative mobilization.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0883-5403
1532-8406
1532-8406
DOI:10.1016/j.arth.2024.12.005