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Overall rate of postoperative complications did not differ between same-day, inpatient TJRs
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Patients who underwent either same-day or inpatient hip and knee arthroplasties had no significant differences in rates of overall postoperative complications or readmission, according to results.
“[There] has been a lot of interest in performing joint replacement surgeries as an outpatient, particularly with the removal of total knee replacement from the inpatient only list,” study co-author Craig J. Della Valle, MD, told Healio.com/Orthopedics. “The questions however that both patients and doctors have is ‘Is it just as safe as a more traditional stay in the hospital?’ Based on our results, it seems that the answer is yes, it is just as safe.”
Using the National Surgical Quality Improvement Program registry, Della Valle and colleagues matched 1,236 patients who had same-day discharge after primary elective total hip arthroplasty, total knee arthroplasty or unicompartmental knee arthroplasty to a cohort of patients who had an inpatient stay. Researchers compared the rates of 30-day adverse events and readmission between the two groups.
Results showed same-day and inpatient groups had no significant differences in overall adverse events or readmission rates. However, researchers found increased thromboembolic events among the inpatient group and increased rates of return to the OR in the same-day surgery group. An increased return to the OR for patients who underwent same-day surgery was the only difference between groups when procedures were assessed individually.
Following same-day surgical procedures, researchers found 30-day readmission was associated with BMI of 35 kg/m2 or more, insulin-dependent diabetes, noninsulin-dependent diabetes and age of 85 years or older. The most common reason for reoperation and readmission following same-day procedures was infection.
Study co-author Bryce A. Basques, MD, told Healio.com/Orthopedics, “[All] patients are not necessarily appropriate/safe for outpatient surgery, but among those who are, it seems that as long as they do not have significant risk factors they can expect no additional risks with an outpatient compared to inpatient procedure.” – by Casey Tingle
Disclosures: Basques reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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