Risk assessment model used to predict discharge care after total hip and total knee arthroplasty: A population-based study.

Autor: Alves H; Institute of Higher Education and Research in Healthcare - IUFRS, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.; University Hospitals of Geneva, Geneva, Switzerland., Di Tommaso S; Institute of Higher Education and Research in Healthcare - IUFRS, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.; University Hospitals of Geneva, Geneva, Switzerland., Wegrzyn J; Department of Orthopaedic, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland., Mabire C; Institute of Higher Education and Research in Healthcare - IUFRS, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
Jazyk: angličtina
Zdroj: Journal of orthopaedics [J Orthop] 2024 Oct 23; Vol. 63, pp. 1-7. Date of Electronic Publication: 2024 Oct 23 (Print Publication: 2025).
DOI: 10.1016/j.jor.2024.10.031
Abstrakt: Background: Transfer to a post-acute care facility or hospital readmission after total joint arthroplasty represent additional costs and increased surgical and health care resource utilization. Accurate prediction of post-acute care factors could help providers to plan the patient's discharge destination and have a positive impact on postoperative outcomes and readmission rates.
Objective: To develop a risk assessment model to predict discharge care after total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Design: A retrospective longitudinal observational study.
Settings: and participants: This study included 209 patients who underwent primary unilateral THA or TKA at a major academic medical center in Switzerland from January 2018 to December 2019.
Methods: A collection of computerized- and paper-recorded data identified the discharge destination, socio-demographic factors, comorbidities, and other factors related to the patient. Univariate and multivariate analyses were performed to describe the predictors of post-surgical discharge destinations.
Results: The characteristics associated with post-acute care after primary unilateral THA or TKA were the absence of a caregiver, advanced age, female gender, presence of walking aids, high ASA score, and comorbidity severity. A prediction model demonstrated that these six characteristics were associated 52 % with discharge to a post-acute care destination.
Conclusions: This study allowed us to identify predictors of discharge to a post-surgical destination. Predictive models can be efficiently used to better predict which patients are predisposed to post-acute care after hospital discharge. Further studies are needed to determine the optimal criteria for different destinations.
(© 2024 The Authors.)
Databáze: MEDLINE
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