Stairs at home associated with discharge to post-acute care facility after TKA
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Key takeaways:
- More unavoidable stairs at home were linked with discharge to a post-acute care center after total knee arthroplasty.
- Stairs should be considered in risk stratification algorithms for surgical patients.
Results published in the Journal of Orthopaedic Experience & Innovation found patients with unavoidable stairs at home are at increased risk for discharge to a post-acute care facility after total knee arthroplasty.
Researchers reviewed data on 540 patients who underwent TKA at single, urban academic medical center from November 2011 to October 2014. Outcomes included number of unavoidable stairs at home, American Society of Anesthesiologists (ASA) scores, risk assessment and prediction tool scores, length of stay, tranexamic acid use and operative time.
Researchers found 64.3% of patients (n = 347) were discharged to a post-acute care facility after TKA, while 35.7% (n = 193) were discharged home. According to the study, male sex, greater number of unavoidable stairs at home , higher ASA score and older patient age were significant risk factors for discharge to a post-acute care facility, while female sex and higher risk assessment and prediction tool scores were protective factors against discharge to a post-acute care facility.
“This finding, in light of the lack of evidence supporting efficacy of [post-acute care facilities], is important both for discharge planning on an individual basis, and for the broader efforts to decrease health care spending,” the researchers wrote in the study. “Most importantly, stairs can be considered in risk stratification algorithms,” they concluded.
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