Experience with reduced post-operative stay in patients with total hip and knee replacement
DOI:
https://doi.org/10.1016/j.rccot.2017.01.004Keywords:
hip arthroplasty, hospital stay, rehabilitation, complicationsAbstract
Background: Hip and knee replacement are predictable in our Hospital, where procedures to improve care processes have led to a shortening of the postoperative stay without increasing complications. The aim of this article is to describe the experience with this reduced hospital stay.
Materials and methods: An observational and prospective study was conducted on patients who underwent to hip and knee arthroplasty between May 2014 and October 2015. An evaluation was made of comorbidities, time of surgery, bleeding, hospital stay, post-operative complications, and re-admissions. A descriptive analysis was performed using frequency tables, and measures of central tendency and dispersion. The 95% confidence interval was calculated for the complications, and the Cochran-Armitage trend test was used for the relationships of variables.
Results: Of the 195 patients, 74 of hip and 121 of knee, there were no postoperative complications associated with knee replacements, but hospital complications were 6.8% in hip replacements. The mean stay for hips was 1.4 days, 2 days for knees. The re-admission rate was 9.7% for hips, and 14% for knees.
Discussion: The rate of hospital complications is similar to that reported by centres with reduced hospital stays. Age in replacement of hip joint was a factor that changed the complications (P<.05). Using a proper selection of patients, a regulated process, and early rehabilitation, it is possible to reduce hospital stay without increasing the early complications. However, more studies are required on the economic impact, as well as the impact on patients.
Evidence level: II.
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