Preoperative pain level and patient expectation predict hospital length of stay after total hip arthroplasty.

Halawi, Mohamad J; Vovos, Tyler J; Green, Cindy L; Wellman, Samuel S; Attarian, David E; Bolognesi, Michael P

doi:10.1016/j.arth.2014.10.033

Abstract

The purpose of this study was to identify preoperative predictors of length of stay after primary total hip arthroplasty in a patient population reflecting current trends toward shorter hospitalization and using readily obtainable factors that do not require scoring systems. A retrospective review of 112 consecutive patients was performed. High preoperative pain level and patient expectation of discharge to extended care facilities (ECFs) were the only significant multivariable predictors of hospitalization extending beyond 2 days (P=0.001 and P<0.001 respectively). Patient expectation remained significant after adjusting for Medicare's 3-day requirement for discharge to ECFs (P<0.001). The study was adequately powered to analyze the variables in the multivariable logistic regression model, which had a concordance index of 0.857.

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https://hdl.handle.net/10161/10287

Published Version (Please cite this version)

10.1016/j.arth.2014.10.033

Publication Info

Halawi, Mohamad J; Vovos, Tyler J; Green, Cindy L; Wellman, Samuel S; Attarian, David E; & Bolognesi, Michael P (2015). Preoperative pain level and patient expectation predict hospital length of stay after total hip arthroplasty. J Arthroplasty, 30(4). pp. 555-558. 10.1016/j.arth.2014.10.033. Retrieved from https://hdl.handle.net/10161/10287.

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Scholars@Duke

David Edward Attarian

Professor of Orthopaedic Surgery

Investigation of value based healthcare markets and transitions. Cost transparency for patients and providers.Risk management and medicolegal aspects of orthopaedic practice. Co-management and alignment relationships between clinicians and hospitals/ health systems in evolving healthcare markets. Clinical outcomes of total hip and knee replacements (primary and revision surgeries, total joint infections, modern bearing surfaces, gait mechanics and balance). Novel surgical

Michael Paul Bolognesi

Professor of Orthopaedic Surgery

As chief of the adult reconstruction service, the majority of my research effort has been directed toward clinical outcomes, implant survivorship, functional recovery, the biology of hip and knee arthritis and cost effectiveness.

Cynthia Lea Green

Associate Professor of Biostatistics & Bioinformatics

Survival Analysis Longitudinal Data Analysis Logistic Regression Missing Data Clinical Trial Methods Maximum Likelihood Methods

Samuel S. Wellman

Associate Professor of Orthopaedic Surgery

My career has primarily focused on clinical care of hip and knee arthritis. I run a busy Adult Reconstruction (hip and knee replacement) practice. I am also Chief of the Orthopedic Surgery service at the Durham VA medical center. In these roles, I work daily with orthopedic residents, and train them to manage these issues both non-operatively and with surgery. I also mentor residents, fellows,and medical students on their research projects, typically in collabora

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