Jonathan R. Danoff
Most patients undergoing total hip arthroplasty may benefit from same-day discharge, according to results published in The Journal of Arthroplasty, as researchers found change in patient preference postoperatively was the main cause of same-day discharge failure.
Among 106 patients undergoing THA preselected for same-day discharge, Jonathan R. Danoff, MD, and colleagues identified reasons for not discharging home on the same day of surgery as the primary outcome, while the proportion of patients who failed same-day discharge and any preoperative patient characteristics that could be linked to failed same-day discharge were secondary outcomes.
Results showed 74% of patients preselected for same-day discharge experienced successful discharge per protocol. Researchers found patient preference, dizziness or hypotension, failure to clear physical therapy, urine retention and pain management were the most common reasons for failure for same-day discharge among the 26% of patients who experienced failure. Multiple allergies, anxiety or depression, obstructive sleep apnea and rheumatoid arthritis were reported by a greater percentage of patients in the failed same-day discharge group, according to results.
“As outpatient joint replacement surgery becomes increasingly accepted by the joint replacement community, it is critical to identify those patients most likely to successfully discharge home on the same day of surgery, especially when choosing to perform this type of surgery in an ambulatory setting, where there is often no option available for the patient to stay in the facility overnight,” Danoff told Healio.com/Orthopedics. “Despite the advances in modern-day rapid rehabilitation and pain management protocols, there is a dearth of published guidelines to assist surgeons with identifying those patients who may be at risk of failing same-day discharge. In this study, we found that same-day discharge can be successfully performed in the majority of pre-selected patients based on specific criteria, with a minimal complication or readmission rate.” – by Casey Tingle
Disclosures: Danoff reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.