Complication rates are not higher after outpatient compared to inpatient fast-track total hip arthroplasty: a propensity-matched prospective comparative study.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-11-01 Epub Date: 2024-08-27 DOI:10.1177/11207000241267977
Aymard de Ladoucette, Julien Godet, Resurg, Jean-Yves Jenny, Sonia Ramos-Pascual, Ankitha Kumble, Jacobus H Muller, Mo Saffarini, Grégory Biette, Philippe Boisrenoult, Damien Brochard, Thomas Brosset, Pascal Cariven, Julien Chouteau, Marc-Pierre Henry, Christophe Hulet
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引用次数: 0

Abstract

Purpose: Concerns remain with regards to safety of fast-track (FT) and especially outpatient procedures. The purpose of this study was to compare complication rates and clinical outcomes of propensity-matched patients who received FT total hip arthroplasty (THA) in outpatient versus inpatient settings. The hypothesis was that 90-day postoperative complication rates of outpatient FT THA would not be higher than after inpatient FT THA.

Methods: This is a prospective study of consecutive patients who received FT THA at various rates of outpatient and inpatient surgery by 10 senior surgeons (10 centres). The decision between outpatient and inpatient surgery was made on a case-by-case basis depending on the surgeon and patient. All patients were followed until 90 days after surgery. Complications, readmissions and reoperations were collected, and their severity was assessed according to Clavien-Dindo. Patients completed Oxford Hip Score (OHS) at the latest follow-up.

Results: Compared to inpatient FT THA, patients scheduled for outpatient FT THA had no significant differences in 90-day postoperative complication rates (10.7% vs. 12.9%, p = 0.129). There were no significant differences between the 2 groups in 90-day readmission rates and reoperation rates, in severity of postoperative complications, and in time of occurrence of postoperative complications.

Conclusions: There were no differences in rates of intraoperative complications, 90-day postoperative complications, readmissions, or reoperations between outpatient and inpatient FT THA. These findings may help hesitant surgeons to move towards outpatient THA pathways as there is no greater risk of early postoperative complications that could be more difficult to manage after discharge.

门诊全髋关节置换术后并发症发生率并不高于住院快速全髋关节置换术:倾向匹配前瞻性比较研究。
目的:快速通道(FT)尤其是门诊手术的安全性仍然令人担忧。本研究旨在比较在门诊和住院环境中接受快速通道全髋关节置换术(THA)的倾向匹配患者的并发症发生率和临床结果。研究假设门诊患者接受假体全髋关节置换术的术后90天并发症发生率不会高于住院患者:这是一项前瞻性研究,由 10 位资深外科医生(10 个中心)对连续接受不同比例门诊和住院手术的 FT THA 患者进行研究。根据外科医生和患者的具体情况决定采用门诊手术还是住院手术。所有患者均在术后 90 天内接受随访。收集并发症、再入院和再次手术的情况,并根据克拉维恩-丁度评估其严重程度。患者在最近一次随访时完成牛津髋关节评分(OHS):与住院全髋关节置换术相比,门诊全髋关节置换术患者的术后90天并发症发生率无显著差异(10.7% vs. 12.9%,P = 0.129)。两组患者在90天再入院率和再次手术率、术后并发症严重程度以及术后并发症发生时间方面均无明显差异:结论:在术中并发症发生率、术后90天并发症发生率、再入院率或再次手术率方面,门诊和住院FT THA之间没有差异。这些发现可能会帮助犹豫不决的外科医生转向门诊 THA 途径,因为术后早期并发症的风险不会更大,出院后可能更难处理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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