Stepping toward outpatient total hip arthroplasty with a rapid discharge protocol

Paul Baker; Samantha N Andrews; Kristin Mathews; Scott Nishioka; Cass K Nakasone

doi:10.1016/j.jor.2021.09.012

Stepping toward outpatient total hip arthroplasty with a rapid discharge protocol

J Orthop. 2021 Oct 2:27:153-157. doi: 10.1016/j.jor.2021.09.012. eCollection 2021 Sep-Oct.

Authors

Paul Baker¹, Samantha N Andrews^{2

3}, Kristin Mathews², Scott Nishioka², Cass K Nakasone^{2

3}

Affiliations

¹ John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA.
² Straub Medical Center, Bone and Joint Center, 888 South King Street, Honolulu, HI, 96813, USA.
³ University of Hawai'i, Department of Surgery, 1356 Lusitana Street, Honolulu, HI, 96813, USA.

Abstract

With total hip arthroplasty no longer an inpatient only procedure, this study retrospectively evaluated the percentage of same day, outpatient (<24 h) and inpatient (>24 h) discharges between 543 standard discharge (SDP) and 372 rapid discharge (RDP) patients. Outpatient discharges increased from 31.9% with SDP to 87.4% with RDP (p < 0.001) and 16.4% achieving same day discharge. Patients not achieving outpatient discharge were more commonly older (odds ratio (OR):1.052, p = 0.003), female (OR:2.715, p = 0.003) and a higher comorbidity classification (OR:2.751, p = 0.002). The 12.6% of patients failing to achieve outpatient discharge suggests that careful patient selection may be necessary to obtain 100% success.

Keywords: Delayed discharge; Inpatient only list; Outpatient; Same day discharge.