Effectiveness, safety and efficiency of next-day discharge versus a 3-day hospital stay after primary total hip arthroplasty.

Abstract

Background: Some studies have proposed reducing unnecessary hospitalization days after total hip arthroplasty (THA) surgery to just a single overnight stay with discharge the morning after surgery. However, the available evidence on patient safety is of poor quality. The main objective was to analyze patient safety after discharge from the hospital the morning after THA surgery (rapid discharge), comparing it with the standard 3-day postoperative stay.

Material and methods: A prospective, non-randomized comparative study was designed to compare two consecutive cohorts over time. The first cohort included patients with a postoperative stay of 3 days, while the second cohort had discharge the morning after surgery. The study evaluated the rate of complications and adverse events both postoperatively and after hospital discharge, as well as pain control using the visual analog scale, functional outcome using the Harris hip scale, patient satisfaction, and economic cost.

Results: The rates of unexpected visits to the emergency room, early complications, readmissions, and reinterventions were similar in both groups, with no significant differences. The functional outcome was also similar in both groups, but the rapid discharge group experienced earlier recovery and significant financial savings.

Conclusion: Rapid discharge, the morning after surgery, is a safe, effective and efficient procedure for primary THA in the majority of patients, with respect to a 3-day stay.