Day-case hip and knee arthroplasty does not increase healthcare system contacts: a prospective multicenter study in a public healthcare setting.

IF 2.5 2区 医学 Q1 ORTHOPEDICS
Abdullahi Abdirisak Hirsi, Oddrún Danielsen, Claus Varnum, Thomas Jakobsen, Mikkel Rathsach Andersen, Manuel Josef Bieder, Søren Overgaard, Christoffer Calov Jørgensen, Henrik Kehlet, Kirill Gromov, Martin Lindberg-Larsen
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引用次数: 0

Abstract

Background and purpose:  Discharge on day of surgery after hip or knee arthroplasty is increasing, but whether this leads to an increase in the overall number of post-discharge healthcare system contacts is unknown. We aimed to investigate whether day-case surgery leads to increased patient-reported healthcare system contacts compared with non-day-case surgery within the first 30 days postoperatively.

Methods:  We performed a prospective multicenter study at seven fast-track centers from September 2022 to August 2023. Candidates for primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or unicompartmental knee arthroplasty (UKA) were evaluated for day-case eligibility using pre-defined criteria. Patients received a survey 30 days postoperatively regarding any healthcare system contacts related to surgery. Planned healthcare visits were excluded. We used day-case eligible patients not discharged on day of surgery (inpatients) as control group.

Results:  Of 2,278 day-case eligible patients, 2,073 (91%) completed the survey, including 1,146 day-case patients (55%) and 927 inpatients (45%). The overall rate of healthcare system contacts was 49% (95% confidence interval [CI] 45-51) in day-case patients compared with 52% (CI 49-56) in inpatients. Specific contacts included visits to a general practitioner (GP) or out-of-hours medical clinic (25% [CI 22-27] vs 32% [CI 29-35]), the emergency department (ED) (6% [CI 4-7] vs 7% [CI 5-8]), and outpatient clinics or wards (35% [CI 33-38] vs 35% [CI 32-38]). The most common reasons for all types of healthcare contacts were wound problems, prescription renewals, and pain management.

Conclusion:  Day-case hip and knee arthroplasties was not associated with increased healthcare system contacts within the first 30 days postoperatively.

一天的病例髋关节和膝关节置换术不会增加医疗保健系统接触:一项在公共医疗机构的前瞻性多中心研究。
背景和目的:髋关节或膝关节置换术后手术当天出院的人数正在增加,但这是否会导致出院后医疗保健系统接触的总人数增加尚不清楚。我们的目的是调查在术后前30天内,与非日间手术相比,日间手术是否会导致患者报告的医疗保健系统接触增加。方法:我们于2022年9月至2023年8月在7个快速通道中心进行了一项前瞻性多中心研究。采用预先定义的标准评估原发性全髋关节置换术(THA)、全膝关节置换术(TKA)或单室膝关节置换术(UKA)的候选人的日病例资格。患者在术后30天接受关于任何与手术相关的医疗保健系统接触的调查。排除了计划的医疗保健访问。我们选择手术当日未出院的日间病例患者(住院患者)作为对照组。结果:在2278例符合条件的日间病例中,2073例(91%)完成了调查,其中包括1146例(55%)日间病例和927例住院患者(45%)。日间病例患者与医疗保健系统接触的总体比率为49%(95%可信区间[CI] 45-51),而住院患者为52% (CI 49-56)。具体接触包括去全科医生(GP)或非工作时间医疗诊所(25% [CI 22-27]对32% [CI 29-35]),急诊科(ED) (6% [CI 4-7]对7% [CI 5-8]),门诊诊所或病房(35% [CI 33-38]对35% [CI 32-38])。所有类型的医疗联系最常见的原因是伤口问题、处方更新和疼痛管理。结论:一天的髋关节和膝关节置换术与术后前30天内医疗保健系统接触的增加无关。
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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
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