A PERIOPERATIVE OPTIMIZATION PROGRAM CAN IMPROVE RESULTS AND REDUCE HOSPITAL LENGTH OF STAY IN HIP AND KNEE ARTHROPLASTY: EXPERIENCE IN CHILE

Abstract

Background and objective: Perioperative optimization programs have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimization program in prosthetic surgery at a Latin American center.

Materials and methods: A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016-2018) and post-intervention (2019-2023) groups following the implementation of a multidisciplinary perioperative optimization program in 2019. The impact of the program on hospital length of stay and 90-day readmission rates was assessed.

Results: A total of 1,462 patients (1,636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1,207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p<0.05). The 90-day readmission rate decreased from 2.56% to 2.24% (p=0.71), with a significant reduction in knee arthrofibrosis (from 0.9% to 0.2%, p<0.05). The optimization program was the main factor contributing to the reduction in hospital length of stay.

Conclusions: The multidisciplinary perioperative program implemented significantly reduced hospital stay without increasing 90-day readmission rates.Furthermore, it equated outcomes between patients with public and private insurance.

Keywords: América Latina; Artroplastia total de cadera; Artroplastia total de rodilla; Cirugía de corta estadía; Estancia hospitalaria; Latin America; Length of stay; Readmisiones; Readmissions; Short Stay Surgery; Total hip arthroplasty; Total knee arthroplasty.