Changes to Anticipated Disposition Prevent Timely Discharge After Total Joint Arthroplasty.

Rade R Jibawi Rivera, Ye Lin, Julio C Castillo Tafur, Asher E Lichtig, Luke Zabawa, Mark H Gonzalez
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Abstract

This study evaluates the impact of preoperative disposition planning on length of stay (LOS) after total joint arthroplasty (TJA). A retrospective chart review, including patients undergoing primary TJA, was performed. Demographics, social factors, Risk Assessment and Prediction Tool (RAPT) scores, and predicted and actual disposition were used to analyze patients that exceeded their expected LOS. Six hundred seventy-nine patients met the inclusion criteria. Average predicted and actual LOS were 2.4 and 2.7 days, respectively. Three hundred thirty-six patients exceeded their anticipated LOS. The most significant factor for exceeding LOS was a change in disposition (p < 0.001). Eighty-two patients had a change in disposition. Patients that required a higher (40) or lower (42) level of care had prolonged LOS (p < 0.001). A change to either higher or lower levels of care than preoperatively anticipated results in increased LOS after TJA. (Journal of Surgical Orthopaedic Advances 34(2):093-097, 2025).

预期处置的改变妨碍全关节置换术后及时出院。
本研究评估术前处置计划对全关节置换术(TJA)后住院时间(LOS)的影响。回顾性图表回顾,包括接受原发性TJA的患者。采用人口统计学、社会因素、风险评估和预测工具(RAPT)评分以及预测和实际处置来分析超过预期LOS的患者。679例患者符合纳入标准。平均预测和实际LOS分别为2.4天和2.7天。336名患者超过了预期的LOS。超过LOS的最重要因素是性格的改变(p < 0.001)。82名患者的性格发生了变化。需要较高(40)或较低(42)护理水平的患者的LOS延长(p < 0.001)。高于或低于术前预期的护理水平会导致TJA后LOS增加。[j] .外科骨科进展34(2):093-097,2025。
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