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

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Date
2015-04
Authors
Halawi, Mohamad J
Vovos, Tyler J
Green, Cindy L
Wellman, Samuel S
Attarian, David E
Bolognesi, Michael P
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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 article
Subject
arthroplasty
hip
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
Permalink
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.
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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Scholars@Duke

Attarian

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
Bolognesi

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.
Green

Cynthia Lea Green

Associate Professor of Biostatistics & Bioinformatics
Survival Analysis Longitudinal Data Analysis Logistic Regression Missing Data Clinical Trial Methods Maximum Likelihood Methods
Wellman

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
Alphabetical list of authors with Scholars@Duke profiles.
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