Hip replacement and hip hemiarthroplasty surgery: potential opportunities to shorten lengths of hospital stay

The American Journal of Medicine
S WeingartenA G Ellrodt

Abstract

The potential safety and effectiveness of a practice guideline recommending a 5-day postoperative stay in the acute care hospital for hip surgery patients without clinical findings predictive of a complicated hospital course was studied retrospectively in 230 patients hospitalized for total hip replacement, total hip replacement with osteotomy, or hip hemiarthroplasty. Seventy percent of total hip replacement and hip hemiarthroplasty patients were classified as being at "low risk" for complications by the guideline (161 patients, or 73% of patients who remained hospitalized). Use of the guideline could have reduced the hospital length of stay from 8.4 days (standard deviation 3.3) to 5.9 days for these selected low-risk patients. Moreover, physicians' implicit review determined that 0% of patients (95% confidence interval, 0% to 2.3%) had a complication that would have benefited from continued stay in an acute care hospital after the fifth postoperative day. Our practice guideline may have the potential to safely reduce acute care hospital length of stay for patients recovering after total hip replacement and hip hemiarthroplasty. The guideline will require further study in a prospective clinical trial before it can be recommen...Continue Reading

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Citations

Dec 6, 2003·The Journal of Arthroplasty·David R MauerhanGary M Kiebzak
Sep 16, 2000·Anesthesiology Clinics of North America·M Karanikolas, R A Swarm
Dec 8, 1998·Journal of Nursing Care Quality·S J CardR Lagoe
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Dec 14, 2004·Arthritis and Rheumatism·Paola de PabloJeffrey N Katz
May 5, 2006·Clinical Orthopaedics and Related Research·Kevin R VincentAlan P Alfano
May 23, 2006·American Journal of Physical Medicine & Rehabilitation·Kevin R VincentAlan P Alfano
Sep 22, 2007·American Journal of Physical Medicine & Rehabilitation·Heather K Vincent, Kevin R Vincent
Jan 24, 2002·American Journal of Physical Medicine & Rehabilitation·S P Grissom, L Dunagan
Jul 19, 2008·Annals of the Royal College of Surgeons of England·Anastasios K LilikakisRichard N Villar
Dec 4, 2004·Clinical Orthopaedics and Related Research·Richard A BergerAaron G Rosenberg

Related Concepts

Arthroplasty
Use-Effectiveness
Hip Joint
Hip Joint Implantable Prostheses (Device)
Hospital Stay
Postoperative Complications
Retrospective Studies
Best Practices

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