Preoperative pain level and patient expectation predict hospital length of stay after total hip arthroplasty.
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.
Type
Journal articleSubject
arthroplastyhip
length of stay
pain
patient expectation
preoperative predictors
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip
Female
Hospitalization
Hospitals
Humans
Length of Stay
Male
Medicare
Middle Aged
Multivariate Analysis
Pain Measurement
Pain, Postoperative
Patient Discharge
Retrospective Studies
Skilled Nursing Facilities
United States
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https://hdl.handle.net/10161/10287Published Version (Please cite this version)
10.1016/j.arth.2014.10.033Publication Info
(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.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@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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