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An Increase in Same-day Discharge After Total Joint Arthroplasty During the COVID-19 Pandemic Does Not Influence Patient Outcomes: A Retrospective Cohort Analysis

التفاصيل البيبلوغرافية
العنوان: An Increase in Same-day Discharge After Total Joint Arthroplasty During the COVID-19 Pandemic Does Not Influence Patient Outcomes: A Retrospective Cohort Analysis
المؤلفون: Brook A. Mitchell, BS, Liam M. Cleary, BS, Linsen T. Samuel, MD, MBA, Benjamin R. Coobs, MD, Miles A. Thomas, BS, Stephen C. Martinkovich, MD, Joseph T. Moskal, MD, FACS
المصدر: Arthroplasty Today, Vol 20, Iss , Pp 101115- (2023)
بيانات النشر: Elsevier, 2023.
سنة النشر: 2023
المجموعة: LCC:Orthopedic surgery
مصطلحات موضوعية: Total hip arthroplasty (THA), Total knee arthroplasty (TKA), Length of stay, Same day discharge, Outpatient, Orthopedic surgery, RD701-811
الوصف: Background: The coronavirus disease 2019 (COVID-19) pandemic caused major transitions in total joint arthroplasty (TJA), notably with the increased utilization of same-day discharge (SDD) pathways. This study assessed the effect of accelerated discharge pathways following the resumption of elective cases during the COVID-19 pandemic on SDD rates, adverse events, and characteristics associated with successful SDD following total hip and total knee arthroplasty. Methods: This retrospective study split patients into cohorts: TJA prior to COVID-19 (pre-COVID, July 2019-December 2019) and TJA following the resumption of elective surgeries (post-COVID, July 2020-December 2020). Patient characteristics such as age, sex, body mass index, American Society of Anesthesiologists score, and pertinent comorbidities were analyzed, and length of stay, 30-day emergency department (ED) visit rates, readmissions, and reoperations were compared. Results: A total of 1333 patients met inclusion criteria that were divided into pre-COVID (692) and post-COVID (641) cohorts. The pre-COVID group had a median age of 69 years (interquartile range 63-76), and the post-COVID group had a median age of 68 years (interquartile range 61-75) (P = .024). SDD increased from 0.1% to 28.9% (P < .001), and length of stay decreased from 1.3 days to 0.89 days (P < .001). There was no change in 30-day ED visits, readmissions, or reoperations (P = .817, P = .470, and P = .643, respectively). There was no difference in ED visits, readmissions, or reoperations in SDD patients. The odds of SDD were associated with age (P < .001, odds ratio [OR] = 0.94), body mass index (P = .006, OR = 0.95), male sex (P < .001, OR = 1.83), and history of tobacco use (P < .001, OR = 1.87). Conclusions: At our institution, the COVID-19 pandemic accelerated the utilization of SDD pathways without increasing ED visits, readmissions, or reoperations.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2352-3441
08111863
Relation: http://www.sciencedirect.com/science/article/pii/S2352344123000201; https://doaj.org/toc/2352-3441
DOI: 10.1016/j.artd.2023.101115
URL الوصول: https://doaj.org/article/f1870921f66c4408b842baf081118631
رقم الأكسشن: edsdoj.f1870921f66c4408b842baf081118631
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:23523441
08111863
DOI:10.1016/j.artd.2023.101115