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Patient selection in outpatient and short-stay total knee arthroplasty
Journal article   Peer reviewed

Patient selection in outpatient and short-stay total knee arthroplasty

Scott Lovald, Kevin Ong, Edmund Lau, Girish Joshi, Steven Kurtz and Arthur Malkani
Journal of surgical orthopaedic advances, v 23(1), pp 2-8
2014
DOI: https://doi.org/10.3113/JSOA.2014.0002
PMID: 24641891

Abstract

Aged Aged, 80 and over Ambulatory Surgical Procedures - adverse effects Arthroplasty, Replacement, Knee - adverse effects Arthroplasty, Replacement, Knee - statistics & numerical data Comorbidity Female Hospitalization - statistics & numerical data Humans Male Mortality Patient Selection Postoperative Complications - epidemiology Postoperative Complications - etiology Reoperation - statistics & numerical data Retrospective Studies Risk Assessment United States - epidemiology
The purpose of the current study is to identify patients who are at high risk for rehospitalization, revision, complications, and mortality after outpatient and short-stay total knee arthroplasty (TKA). The Medicare 5% limited data set sample was used to identify patients with a TKA procedure who were treated in an outpatient setting or who were discharged within 1 or 2 days in the hospital setting. Rehospitalization risk increased with higher Charlson score (i.e., poorer health status), older patients, inpatients (vs. outpatients), patients not receiving a femoral nerve block, earlier (vs. recent) year of surgery, and those with a recent history of heart failure. The findings of this study suggest that existing comorbidities, particularly heart failure, have the greatest effect on event risk after outpatient and short-stay TKA. The information obtained from this study should assist with patient selection for TKA performed on an outpatient basis.

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