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

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2015-04

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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.

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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

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https://hdl.handle.net/10161/10288

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10.1016/j.arth.2014.10.031

Publication Info

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

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Scholars@Duke

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

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 collaboration with my clinical partner, Michael Bolognesi, MD.  We often have multiple residents working on a variety of projects at once.  My research interests lie mainly with clinical research in hip and knee replacement, including biomechanical studies, outcomes research, and clinical trials. I have also begun collaborating with basic science colleagues on biomarker research

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