Same-Day Discharge Increasing for Hip, Knee Arthroplasty
Faster increase seen for total hip arthroplasty, while total knee arthroplasty has slightly higher odds of complications
THURSDAY, Jan. 20, 2022 (HealthDay News) -- Same-day discharge (SDD) is becoming more common for both total hip arthroplasty (THA) and total knee arthroplasty (TKA), according to a study recently published online in the Journal of Arthroplasty.
Eytan M. Debbi, M.D., Ph.D., from the Hospital for Special Surgery in New York City, and colleagues used the PearlDiver All-Payer database to assess trends in primary, elective THA/TKA cases between 2010 and 2017.
The researchers found that of the 1,789,601 patients identified (68.8 percent TKA and 31.2 percent THA), 2.9 percent of TKAs and 2.2 percent of THAs were SDD. There was an increase in annual SDD rates, with a 15.8 percent mean annual change for SDD-THA and 11.1 percent for SDD-TKA. SDD patients were significantly younger and had fewer comorbidities. Overall, there was a slightly higher risk for complications requiring readmission for SDD-TKA versus non-SDD-TKA (odds ratio, 1.14; 95 percent confidence interval, 1.07 to 1.21; P < 0.001). For THA, there was no significant difference observed between SDD and non-SDD (odds ratio, 1.03; 95 percent confidence interval, 0.94 to 1.13; P = 0.49). SDD-THA led to more mechanical complications than SDD-TKA, but fewer pulmonary embolisms. There was a trend toward a higher risk for complications for SDD-THA versus SDD-TKA (odds ratio, 1.19; 95 percent confidence interval, 0.99 to 1.44; P = 0.05).
"SDD is becoming more common and likely safe with appropriate patient selection and postoperative monitoring," the authors write.
One author disclosed financial ties to the biomedical industry.
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