Patient expectation is the most important predictor of discharge destination after primary total joint arthroplasty.
Abstract
The purpose of this study was to identify preoperative predictors of discharge destination
after total joint arthroplasty. A retrospective study of three hundred and seventy-two
consecutive patients who underwent primary total hip and knee arthroplasty was performed.
The mean length of stay was 2.9 days and 29.0% of patients were discharged to extended
care facilities. Age, caregiver support at home, and patient expectation of discharge
destination were the only significant multivariable predictors regardless of the type
of surgery (total knee versus total hip arthroplasty). Among those variables, patient
expectation was the most important predictor (P < 0.001; OR 169.53). The study was
adequately powered to analyze the variables in the multivariable logistic regression
model, which had a high concordance index of 0.969.
Type
Journal articleSubject
arthroplastydischarge destination
hip
knee
patient expectation
preoperative predictors
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Female
Humans
Length of Stay
Logistic Models
Male
Middle Aged
Patient Discharge
Retrospective Studies
Skilled Nursing Facilities
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https://hdl.handle.net/10161/10288Published Version (Please cite this version)
10.1016/j.arth.2014.10.031Publication Info
(2015). Patient expectation is the most important predictor of discharge destination after
primary total joint arthroplasty. J Arthroplasty, 30(4). pp. 539-542. 10.1016/j.arth.2014.10.031. Retrieved from https://hdl.handle.net/10161/10288.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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