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J Arthroplasty. 2015 Apr;30(4):521-6. doi: 10.1016/j.arth.2015.01.023. Epub 2015 Jan 23.

Rapid recovery protocols for primary total hip arthroplasty can safely reduce length of stay without increasing readmissions.

Author information

1
Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, Missouri. Electronic address: jeffrey.stambough@gmail.com.
2
Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, Missouri.
3
Washington University School of Medicine, Division of Biostatistics, St. Louis, Missouri.

Abstract

We sought to investigate the impact of incremental perioperative recovery protocol changes on hospital LOS and readmission rates associated with primary THAs. A total of 1751 cases were assigned to one of four protocol cohorts across 13 years: traditional, enhanced pain management, early mobility, and rapid recovery (RR). LOS significantly decreased between sequential eras and by 52% between the traditional and RR pathways (IRR=0.48; 95% CI 0.44, 0.53; P<0.0001) without an overall increase in 30-day readmission rates (P=0.13). The odds of readmission for THAs performed under the RR pathway were almost one-third those of the traditional era (OR=0.36; 95% CI 0.14, 0.93; P=0.04). Accelerated clinical care protocols should be considered for most patients undergoing primary THA.

KEYWORDS:

THA; length of stay; perioperative protocols; rapid recovery; readmissions

PMID:
25683296
PMCID:
PMC4607279
DOI:
10.1016/j.arth.2015.01.023
[Indexed for MEDLINE]
Free PMC Article

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