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. 2015 Apr;30(4):521-6.
doi: 10.1016/j.arth.2015.01.023. Epub 2015 Jan 23.

Rapid recovery protocols for primary total hip arthroplasty can safely reduce length of stay without increasing readmissions

Jeffrey B Stambough  1 , Ryan M Nunley  2 , Madelyn C Curry  2 , Karen Steger-May  3 , John C Clohisy  2
Affiliations

Rapid recovery protocols for primary total hip arthroplasty can safely reduce length of stay without increasing readmissions

Jeffrey B Stambough et al. J Arthroplasty. 2015 Apr.

Abstract

We sought to investigate the impact of incremental perioperative recovery protocol changes on hospital LOS and readmission rates associated with primary THAs. A total of 1751 cases were assigned to one of four protocol cohorts across 13 years: traditional, enhanced pain management, early mobility, and rapid recovery (RR). LOS significantly decreased between sequential eras and by 52% between the traditional and RR pathways (IRR=0.48; 95% CI 0.44, 0.53; P<0.0001) without an overall increase in 30-day readmission rates (P=0.13). The odds of readmission for THAs performed under the RR pathway were almost one-third those of the traditional era (OR=0.36; 95% CI 0.14, 0.93; P=0.04). Accelerated clinical care protocols should be considered for most patients undergoing primary THA.

Keywords: THA; length of stay; perioperative protocols; rapid recovery; readmissions.

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Figures

Figure 1
Figure 1
Flow diagram of case enrollment and surgical treatment era allocation. * THA = total hip arthroplasty; PCA = patient-controlled analgesia
See this image and copyright information in PMC

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