Predictive factors for discharge destination after total hip arthroplasty

J Orthop Sci. 2023 Jul;28(4):802-805. doi: 10.1016/j.jos.2022.05.005. Epub 2022 Jun 9.

Abstract

Background: This study aimed to investigate factors affecting discharge to an inpatient rehabilitation facility or home following total hip arthroplasty, using a clinical pathway in Japan.

Methods: Five hundred hips with osteoarthritis who underwent unilateral total hip arthroplasty at our institution, with no deviation from the pathway, were included in this retrospective study. The variables were examined by univariate analysis. Multivariate logistic regression analysis was used to identify the independent factors that influenced the discharge outcome.

Results: Four hundred and thirty-four hips were discharged home directly, and 66 were discharged to an inpatient rehabilitation facility. Patients discharged to an inpatient rehabilitation facility were significantly older, shorter, lighter, and more likely to live alone. Additionally, the preoperative clinical score was significantly lower in the inpatient rehabilitation facility Group for all items. Logistic regression analysis showed a significant association between being discharged to an inpatient rehabilitation facility and higher age [odds ratio 3.87, 95% confidence interval 2.03-7.38, P < 0.001], lower total score in the preoperative Japanese Orthopaedic Association hip score [odds ratio 2.42, 95% confidence interval 1.38-4.23, P = 0.002] and living alone [odds ratio 1.84, 95% confidence interval 1.01-3.35, P = 0.046].

Conclusions: In this study, age, the preoperative Japanese Orthopaedic Association hip score, and living arrangement impacted the discharge destination after THA.

Keywords: Clinical pathways; Factors affecting discharge destination; Total hip arthroplasty.

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • Humans
  • Osteoarthritis*
  • Patient Discharge
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Risk Factors