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    Patient expectation is the most important predictor of discharge destination after primary total joint arthroplasty.

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    Date
    2015-04
    Authors
    Attarian, David Edward
    Bolognesi, Michael Paul
    Green, CL
    Halawi, MJ
    Vovos, TJ
    Wellman, Samuel S
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    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 article
    Subject
    arthroplasty
    discharge 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
    Permalink
    https://hdl.handle.net/10161/10288
    Published Version (Please cite this version)
    10.1016/j.arth.2014.10.031
    Publication Info
    Attarian, David Edward; Bolognesi, Michael Paul; Green, CL; Halawi, MJ; Vovos, TJ; & Wellman, Samuel S (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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    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.
    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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